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Amanda Leigh Hawkins, LPC

Individual provider Active NPI Professional Counselor · Moulton, AL

NPI 1902090780 · NPPES record last updated Apr 25, 2018

Key facts

NPI
1902090780
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
3203 (AL)
Practice address
295 Hospital St
Moulton, AL 35650-1210
Phone
(256) 974-6697
NPI assigned
Sep 5, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
3203ALMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Center of North Central Alabama Inc. Past
since Nov 24, 2015		 Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Case Manager/Care Coordinator 171M00000X
Professional Counselor 101YP2500X 3203 AL Yes

Addresses

Primary practice location

295 Hospital St
Moulton, AL 35650-1210

Mailing address

1316 Somerville Rd SE
Suite 1
Decatur, AL 35601-4305
Phone (256) 355-6105

Other names

  • Amanda Leight Tucker Former name

Other providers in Moulton, AL

All providers in Moulton, AL · Professional Counselor in Alabama

Sources for this page

Verify at the official NPI Registry.