Lis, Amanda L

Lis, Amanda L is an sole proprietor health care provider with primary practice located at 360 N Caswell Rd , Charlotte NC 28204-2442. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Lis, Amanda L can be contacted via phone (704) 421-4887.

Contact Information

Primary practice address
360 N Caswell Rd Charlotte NC 28204-2442
Phone: (704) 421-4887
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 1139 North Carolina

Profile Details

NPI number 1477602779
LBN Legal business name Lis, Amanda L
Credentials MS, LMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 9th, 2007
Last updated Nov 27th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477602779 NPPES
North Carolina MEDICAID 6105139

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