Provider Demographics
NPI:1861833733
Name:MILLER, AMANDA WHATLEY (MA, LPC-SA)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:WHATLEY
Last Name:MILLER
Suffix:
Gender:F
Credentials:MA, LPC-SA
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:W
Other - Last Name:POWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC-S
Mailing Address - Street 1:77 HIGHWAY 135
Mailing Address - Street 2:
Mailing Address - City:RAYVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71269-5556
Mailing Address - Country:US
Mailing Address - Phone:318-235-4798
Mailing Address - Fax:
Practice Address - Street 1:1900 N 18TH ST STE 412
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-4419
Practice Address - Country:US
Practice Address - Phone:318-235-4798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-08
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4845251S00000X, 101YP2500X, 101Y00000X, 101YA0400X, 101YM0800X, 101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No251S00000XAgenciesCommunity/Behavioral Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool