Provider Demographics
NPI:1699363986
Name:LUCIUS, AMANDA CAROLE (MA LMFT)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:CAROLE
Last Name:LUCIUS
Suffix:
Gender:
Credentials:MA LMFT
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:CAROLE
Other - Last Name:WESTLIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5860 BAKER RD
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-5903
Mailing Address - Country:US
Mailing Address - Phone:952-767-4200
Mailing Address - Fax:952-767-4211
Practice Address - Street 1:111 11TH AVE NE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:MN
Practice Address - Zip Code:55912-3316
Practice Address - Country:US
Practice Address - Phone:952-767-4200
Practice Address - Fax:952-767-4211
Is Sole Proprietor?:No
Enumeration Date:2021-01-04
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN4070OtherMINNESOTA BOARD OF MARRIAGE AND FAMILY THERAPY