Provider Demographics
NPI:1053884288
Name:MONROE, AMANDA RENEE (MA, LPC, NCC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:RENEE
Last Name:MONROE
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:467 TERRACE LAKE DR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70435-5413
Mailing Address - Country:US
Mailing Address - Phone:985-285-7181
Mailing Address - Fax:
Practice Address - Street 1:206 S TYLER ST STE C
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-3073
Practice Address - Country:US
Practice Address - Phone:985-200-0799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-10
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7665101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor