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General NPI Number Information
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NPI Number | 1497881304
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Entity Type | Individual
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Provider Name | AMANDA OWEN UNDERWOOD M.A., LPC-S
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Gender | Female
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 01/10/2022
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Provider Practice Location Address
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Address Line | 6010 W SPRING CREEK PKWY STE 232
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City | PLANO
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State | TX
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Zip | 75024-3569
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Country | US
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Telephone | 469-767-6888
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Fax | 972-848-9777
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Provider Business Mailing Address
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Address Line | 3615 FOXBORO LN
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City | CARROLLTON
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State | TX
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Zip | 75007-2937
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Country | US
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Telephone | 469-767-6888
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Fax | 972-848-9777
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 19882
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 19882
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License Number State | TX
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