Provider Demographics
NPI:1861213183
Name:MINEO, AMANDA MARIE (LMHC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARIE
Last Name:MINEO
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 1:34032 SKY BLOSSOM CIR
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34788-3328
Mailing Address - Country:US
Mailing Address - Phone:954-937-9247
Mailing Address - Fax:
Practice Address - Street 1:9757 PINE LAKE DR APT 1059
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-6151
Practice Address - Country:US
Practice Address - Phone:832-245-1785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-19
Last Update Date:2024-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH18758101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health