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NPI Code Detail

MEDICARE: MS. AMANDA KAY LMFT

MEDICARE: MS. AMANDA KAY LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2106H00000XMarriage & Family Therapist12137511-3902UT
3106H00000XMarriage & Family TherapistMFT001595GA
4106H00000XMarriage & Family Therapist01422NV

General Provider Information

NPI Number : 1265737340
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AMANDA KAY LMFT
Provider Business Mailing Address
First Line : 996 N 2750 W
Second Line :
City : CLINTON
State : UT
Zip : 84015-7587
Country : US
Telephone Number : 702-416-0139
Fax Number :
Provider Business Practice Location Address
First Line : 990 VILLA ST
Second Line :
City : MOUNTAIN VIEW
State : CA
Zip : 94041-1236
Country : US
Telephone Number : 702-416-0139
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2011
Last Update Date : 12/09/2023

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