Nellis, Amanda Christine
Nellis, Amanda Christine is an sole proprietor health care provider with primary practice located at 7301 N 16Th St Ste 102 , Phoenix AZ 85020-5266. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Counseling is her primary health care specialty. Nellis, Amanda Christine can be contacted via phone (602) 734-0213.Contact Information
Primary practice address
7301 N 16Th St Ste 102
Phoenix AZ 85020-5266
Phone: (602) 734-0213
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counseling | 103TC1900X | 4016 | Arizona |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | LPC-2216 | Arizona |
Profile Details
| NPI number | 1265442628 |
|---|---|
| LBN Legal business name | Nellis, Amanda Christine |
| Credentials | PH.D., LPC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 9th, 2006 |
| Last updated | Jul 13th, 2022 - about 3 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 | 1265442628 | NPPES |
| Arizona | MEDICAID | 579401 |
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