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General NPI Number Information
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NPI Number | 1831220698
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Entity Type | Individual
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Provider Name | AMANDA MCNURE LPC
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Gender | Female
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 05/04/2022
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Provider Practice Location Address
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Address Line | 8626 AIRWAYS BLVD
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City | SOUTHAVEN
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State | MS
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Zip | 38671-2603
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Country | US
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Telephone | 662-772-5937
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Fax | 662-772-5940
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Provider Business Mailing Address
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Address Line | PO BOX 256
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City | SWAINSBORO
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State | GA
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Zip | 30401-0256
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Country | US
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Telephone | 478-419-1266
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Fax | 478-419-1267
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | APC001506
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License Number State | GA
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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 | LPC005541
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2793
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License Number State | MS
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