Provider Demographics
NPI:1588154074
Name:BRILEY, AMANDA (LCPC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:BRILEY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 W HUFFAKER LN STE 105
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-2098
Mailing Address - Country:US
Mailing Address - Phone:775-686-0184
Mailing Address - Fax:775-252-3944
Practice Address - Street 1:150 W HUFFAKER LN STE 105
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2098
Practice Address - Country:US
Practice Address - Phone:775-686-0184
Practice Address - Fax:775-252-3944
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-10
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61302645101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health