Provider Demographics
NPI:1972742500
Name:BARNETT, AMANDA LYNN (EDS, NCC, LPC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LYNN
Last Name:BARNETT
Suffix:
Gender:F
Credentials:EDS, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7960 WILLOW PT
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30506-7933
Mailing Address - Country:US
Mailing Address - Phone:678-978-8880
Mailing Address - Fax:
Practice Address - Street 1:7960 WILLOW PT
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30506-7933
Practice Address - Country:US
Practice Address - Phone:678-978-8880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-04
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005481101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional