Wyatt, Amanda M

Wyatt, Amanda M is an individual health care provider with primary practice located at 601 Wall St , Valparaiso IN 46383-2512. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Wyatt, Amanda M can be contacted via phone (219) 531-3500.

Contact Information

Primary practice address
601 Wall St Valparaiso IN 46383-2512
Phone: (219) 531-3500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 180-005554 Illinois
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 39001619A Indiana

Profile Details

NPI number 1245221043
LBN Legal business name Wyatt, Amanda M
Credentials MA, ATR-BC, LMHC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 31st, 2005
Last updated Jun 1st, 2010 - about 14 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 1245221043 NPPES
Illinois Other 180-005554 LCPC
Illinois Other 39001619A LCPC
Illinois Other 04-139 LCPC

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