Provider Demographics
NPI:1568279594
Name:OLNEY, AMANDA (LMHCA)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:OLNEY
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:ROBERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED COUNSELING
Mailing Address - Street 1:40428 202ND AVE SE
Mailing Address - Street 2:
Mailing Address - City:ENUMCLAW
Mailing Address - State:WA
Mailing Address - Zip Code:98022-8902
Mailing Address - Country:US
Mailing Address - Phone:206-819-2618
Mailing Address - Fax:
Practice Address - Street 1:40428 202ND AVE SE
Practice Address - Street 2:
Practice Address - City:ENUMCLAW
Practice Address - State:WA
Practice Address - Zip Code:98022-8902
Practice Address - Country:US
Practice Address - Phone:206-819-2618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-13
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61575672101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health