Basic Information
| Provider Information | |||||||||
| NPI: | 1265815351 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AMANDA PATTERSON, LMHC, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9000 SHERIDAN ST | ||||||||
| Address2: | #110 & 112 | ||||||||
| City: | PEMBROKE PINES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330248802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543785381 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9000 SHERIDAN ST | ||||||||
| Address2: | #110 & 112 | ||||||||
| City: | PEMBROKE PINES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330248802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543785381 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2015 | ||||||||
| LastUpdateDate: | 07/07/2015 | ||||||||
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| AuthorizedOfficialLastName: | PATTERSON | ||||||||
| AuthorizedOfficialFirstName: | AMANDA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9542588845 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LMHC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0801X | MH10243 | FL | N | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | 101YM0800X | MH10243 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.