Amanda Cordova, LPC- S

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

61122 Issued in TX

Practice address

115 N University Dr Ste a
Nacogdoches, TX 75961-5126

Phone

(936) 371-1172

Fax

(866) 598-3817

NPI assigned

Jan 26, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 14, 2024 through Feb 14, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cordova Counseling Services PLLC

  • Professional Counselor
  • Nacogdoches, TX
  • NPI 1427742196
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1422230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1407246770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 N UNIVERSITY DR STE A",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759615126",
            "telephone_number": "936-371-1172",
            "fax_number": "866-598-3817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N UNIVERSITY DR STE A",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759615126",
            "telephone_number": "936-371-1172",
            "fax_number": "866-598-3817"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2214 N Pecan St",
            "address_purpose": "LOCATION",
            "city": "Nacogdoches",
            "state": "TX",
            "postal_code": "759653502",
            "country_code": "US",
            "telephone_number": "936-560-6855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORDOVA",
        "first_name": "AMANDA",
        "credential": "LPC- S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-26",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "61122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Elaine Cooper, FNP-C
• Haskell Cooper, PHD, LCSW
• John Darren Copen, CRNA
• Misty Copen, FNP-C
• Cordova Counseling Services PLLC
• Caroline Chance Corley, NP
• Cox Christian Counseling PLLC
• Brooke Elaine Cox
• Felicia Cox, LPC
• Kayla Cox, LCSW

• Professional Counselor in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.