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General NPI Number Information
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NPI Number | 1407705460
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Entity Type | Organization
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Legal Business Name | AMANDA BALLEW LPC LLC
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Dates
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Enumeration Date | 01/23/2026
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 26 E MEADOW ST STE 11
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City | FAYETTEVILLE
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State | AR
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Zip | 72701-5357
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Country | US
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Telephone | 314-596-1367
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Fax |
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Provider Business Mailing Address
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Address Line | 26 E MEADOW ST STE 11
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City | FAYETTEVILLE
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State | AR
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Zip | 72701-5357
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Country | US
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Telephone | 314-596-1367
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMANDA BALLEW
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Credential | LPC
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Telephone | 314-596-1367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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