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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477602779 | NPPES |
| North Carolina | MEDICAID | 6105139 |
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