Provider Demographics
NPI:1528243847
Name:ALLIE, AMANDA LYN (LMHC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LYN
Last Name:ALLIE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:LYN
Other - Last Name:MORSTAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6005 S OAKES ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-6115
Mailing Address - Country:US
Mailing Address - Phone:360-379-7387
Mailing Address - Fax:
Practice Address - Street 1:6005 S OAKES ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-6115
Practice Address - Country:US
Practice Address - Phone:360-379-7387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-05
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00055845101Y00000X
WALH60903002101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor