MEDICARE: AMANDA CLAUSEN MA, LPC

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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1962880922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA CLAUSEN MA, LPC

Provider Business Mailing Address
First Line	:	PO BOX 557
Second Line	:
City	:	BROOMFIELD
State	:	CO
Zip	:	80038-0557
Country	:	US
Telephone Number	:	970-302-4970
Fax Number	:	720-302-2334

Provider Business Practice Location Address
First Line	:	80 GARDEN CTR STE 131
Second Line	:
City	:	BROOMFIELD
State	:	CO
Zip	:	80020-2622
Country	:	US
Telephone Number	:	970-302-4970
Fax Number	:	720-302-2334

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2015
Last Update Date	:	01/03/2024

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