1467780452 NPI number — MRS. AMANDA HART FRANKE LMFT, CDP

Table of content: MRS. AMANDA HART FRANKE LMFT, CDP (NPI 1467780452)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467780452 NPI number — MRS. AMANDA HART FRANKE LMFT, CDP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRANKE
Provider First Name:
AMANDA
Provider Middle Name:
HART
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMFT, CDP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HART
Provider Other First Name:
AMANDA
Provider Other Middle Name:
CATHERINE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMFT, CDP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1467780452
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/03/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6160 NE 185TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KENMORE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98028-8910
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
773-456-7204
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6160 NE 185TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KENMORE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98028-8910
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-456-7204
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/02/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  LF60292056 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YA0400X , with the licence number: CP60234166 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1467780452 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".