Provider Demographics
NPI:1659968774
Name:ROBERTS, AMANDA (LMHC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1559 W NINE MILE RD APT 1322
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32534-5387
Mailing Address - Country:US
Mailing Address - Phone:317-847-9609
Mailing Address - Fax:
Practice Address - Street 1:600 UNIVERSITY OFFICE BLVD # 10
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-6475
Practice Address - Country:US
Practice Address - Phone:850-805-8733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-22
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
FLMH26132101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician