Provider Demographics
NPI:1962894832
Name:BURRAFATO, AMANDA MARIE (LMFT, LCASA)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARIE
Last Name:BURRAFATO
Suffix:
Gender:F
Credentials:LMFT, LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-5954
Mailing Address - Country:US
Mailing Address - Phone:252-438-4145
Mailing Address - Fax:252-438-6405
Practice Address - Street 1:300 W PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-5954
Practice Address - Country:US
Practice Address - Phone:252-438-4145
Practice Address - Fax:252-438-6405
Is Sole Proprietor?:No
Enumeration Date:2015-03-02
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-23033101YA0400X
NC1793106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)