Provider Demographics
NPI:1588124226
Name:WEILHAMMER, AMANDA DESIREE (LMHC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:DESIREE
Last Name:WEILHAMMER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:DESIREE
Other - Last Name:CHIFOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:2240 N MERIDIAN ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46208-5728
Mailing Address - Country:US
Mailing Address - Phone:317-644-7221
Mailing Address - Fax:317-464-9575
Practice Address - Street 1:2240 N MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46208-5728
Practice Address - Country:US
Practice Address - Phone:317-634-6341
Practice Address - Fax:317-464-9575
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39003432A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health