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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932374584 | NPPES |
| Georgia | Other | 004810 | GEORGIA LICENSURE BOARD |
| Georgia | MEDICAID | LPC004810 | GEORGIA LICENSURE BOARD |
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