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General NPI Number Information
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NPI Number | 1558965285
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Entity Type | Individual
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Provider Name | AMANDA KAY BURD LPCC
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Gender | Female
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Dates
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Enumeration Date | 11/23/2020
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Last Update Date | 01/12/2021
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Provider Practice Location Address
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Address Line | 401 S GREEN ST
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City | GLASGOW
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State | KY
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Zip | 42141-2555
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Country | US
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Telephone | 770-746-4357
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Fax | 270-213-7026
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Provider Business Mailing Address
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Address Line | PO BOX 625
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City | GLASGOW
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State | KY
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Zip | 42142-0625
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Country | US
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Telephone | 702-746-4357
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Fax | 270-213-7026
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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 | 267079
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License Number State | KY
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