Provider Demographics
NPI:1376758375
Name:BROWN, AMANDA N (MA, LPCC)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:N
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 DON PASQUAL RD NW
Mailing Address - Street 2:
Mailing Address - City:LOS LUNAS
Mailing Address - State:NM
Mailing Address - Zip Code:87031-8841
Mailing Address - Country:US
Mailing Address - Phone:505-865-4618
Mailing Address - Fax:
Practice Address - Street 1:145 DON PASQUAL RD NW
Practice Address - Street 2:
Practice Address - City:LOS LUNAS
Practice Address - State:NM
Practice Address - Zip Code:87031-8841
Practice Address - Country:US
Practice Address - Phone:505-841-8654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCCMH0185801101YM0800X
NM0126581101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)