Mungo, Amani Amanda

Mungo, Amani Amanda is an sole proprietor health care provider with primary practice located at 1830 Water Pl Se Ste 215 , Atlanta GA 30339-7407. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Mungo, Amani Amanda can be contacted via phone (470) 326-6469.

Contact Information

Primary practice address
1830 Water Pl Se Ste 215 Atlanta GA 30339-7407
Phone: (470) 326-6469
Fax: (678) 853-2466
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 004810 Georgia
Behavioral Health & Social Service Providers / Professional 101YP2500X LPC004810 Georgia

Profile Details

NPI number 1932374584
LBN Legal business name Mungo, Amani Amanda
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 24th, 2008
Last updated Feb 3rd, 2022 - about 2 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 1932374584 NPPES
Georgia Other 004810 GEORGIA LICENSURE BOARD
Georgia MEDICAID LPC004810 GEORGIA LICENSURE BOARD

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