Provider Demographics
NPI:1063952679
Name:MCGRAW, AMANDA (MS, PLPC, NCC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:MCGRAW
Suffix:
Gender:F
Credentials:MS, PLPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9378 RUE DE BENOIT
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70706-1508
Mailing Address - Country:US
Mailing Address - Phone:225-247-3135
Mailing Address - Fax:
Practice Address - Street 1:8755 SULLIVAN RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70818-6030
Practice Address - Country:US
Practice Address - Phone:225-247-3135
Practice Address - Fax:225-427-8710
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-01
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6946101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor