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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 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 1265442628 NPPES
Arizona MEDICAID 579401

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