Provider Demographics
NPI:1528511391
Name:LLOYD, AMANDA (MFT-INTERN)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:LLOYD
Suffix:
Gender:F
Credentials:MFT-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10175 SPRING MOUNTAIN RD UNIT 2118
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-8481
Mailing Address - Country:US
Mailing Address - Phone:702-335-7135
Mailing Address - Fax:
Practice Address - Street 1:203 S WATER ST # 200
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-7226
Practice Address - Country:US
Practice Address - Phone:702-823-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-28
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225400000X
NVMI0928106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner