AMANDA L LIS (NPI# 1477602779) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477602779 |
| Entity Type | Individual |
| Full Name | AMANDA L LIS |
| Other Name | AMANDA L GRIMMETT |
| Credential | MS, LMFT |
| Practice Address |
360 N Caswell Rd Charlotte NC 28204-2442 |
| Mailing Address |
8041 Stoneham Ct Matthews NC 28105-6435 |
| Practice Telephone | 7044214887 |
| Mailing Telephone | 7044214887 |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2012-11-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 1139 | NC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6105139 | 05 |
| Street Address |
360 N CASWELL RD |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28204-2442 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891861431 | Heather L Douglas | Social Worker | 360 N Caswell Rd, Charlotte, NC 28204-2442 | 2006-11-27 |
| 1053798017 | Carrie Lynn Patterson Barto | Counselor | 360 N Caswell Rd, Charlotte, NC 28204-2442 | 2015-04-29 |
| 1447643325 | Shelly Marie Luttman Phelps | Social Worker | 360 N Caswell Rd, Charlotte, NC 28204 | 2015-03-16 |
| 1689009565 | Ama Owusuaa | Counselor | 360 N Caswell Rd, Charlotte, NC 28204-2442 | 2013-09-10 |
| 1881932333 | Jenna E Wilson | Social Worker | 360 N Caswell Rd, Charlotte, NC 28204-2442 | 2013-01-17 |
| 1326311697 | Rush Counseling Services | Community/Behavioral Health | 360 N Caswell Rd, Charlotte, NC 28204-2442 | 2012-02-17 |
| 1013205459 | Emily Teague Palmieri | Counselor | 360 N Caswell Rd, Charlotte, NC 28204-2442 | 2011-07-19 |
| 1891850970 | Laura H Frohboese | Social Worker | 360 N Caswell Rd, Charlotte, NC 28204-2442 | 2006-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285263582 | Precise Home Care Service LLC | In Home Supportive Care | 1935 Baxter Street, Unit 101, Charlotte, NC 28204 | 2020-04-07 |
| 1285276253 | Shannon Miller | Counselor | 1432 E Seventh Street, Charlotte, NC 28204 | 2019-10-11 |
| 1194282202 | Madison Joann Mcgarrigle | Behavior Technician | 1401 East 7th Street, Charlotte, NC 28204 | 2019-02-25 |
| 1255802674 | Stacey D. Alston, Dds, Pa | Dentist | 1020 E. 10th St., Suite 1, Charlotte, NC 28204 | 2018-12-11 |
| 1972082097 | Kim Webb Talbert | Nurse Practitioner | Novant Health Presbyterian Medical Center Charlotte, 200 Hawthorne Lane, Charlotte, NC 28204 | 2018-08-09 |
| 1164910535 | Jesse Elijah Roberts | Counselor | 1801 E 5th Street, #208, Charlotte, NC 28204 | 2018-05-01 |
| 1336696848 | Eight Healthcare | Exclusive Provider Organization | 2455 Weddington Ave, 2110, Charlotte, NC 28204 | 2016-09-01 |
| 1225480551 | Kathleen Quintana Bradley | Physician Assistant | 1523 Elizabeth Ave., Suite 200, Charlotte, NC 28204 | 2016-07-11 |
| 1184049777 | Della Franklin | Speech-Language Pathologist | 1021 Morehead Medical Dr Ste 3300, Charlotte, NC 28204 | 2014-02-19 |
| 1225459845 | Healing Arts Medical, Pa | Family Medicine | 335 N. Caswell Rd., Charlotte, NC 28204 | 2013-12-27 |
| Find all providers in zip 28204 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841491 | Emily Brokaw | Marriage & Family Therapist | 10420 Park Rd # 100-b, Charlotte, NC 28210-8501 | 2020-11-05 |
| 1215550074 | Tiffany Guy | Marriage & Family Therapist | 4219 Springhaven Dr, Charlotte, NC 28269-1629 | 2020-05-27 |
| 1013557867 | Sandra May Kamara | Marriage & Family Therapist | 6601 Barrington Dr, Charlotte, NC 28215-3401 | 2020-01-09 |
| 1053958868 | Karen M Quigley | Marriage & Family Therapist | 6000 Fairview Rd Fl 12, Charlotte, NC 28210-2224 | 2019-11-30 |
| 1386288421 | Tiffany De Leon | Marriage & Family Therapist | 13735 Steele Creek Rd, Charlotte, NC 28273-6841 | 2019-11-01 |
| 1841833761 | Sweeneypsych, Pllc | Marriage & Family Therapist | 811 Central Ave Ste 8, Charlotte, NC 28204-2015 | 2019-10-23 |
| 1144871476 | Linda Joann Mullinix | Marriage & Family Therapist | 3835 W W T Harris Blvd, Charlotte, NC 28269-3500 | 2019-09-27 |
| 1497316012 | Shantel Lynette Smythe | Marriage & Family Therapist | 5700 Executive Center Dr Ste 200, Charlotte, NC 28212-8833 | 2019-06-25 |
| 1073174975 | Monica Pena | Marriage & Family Therapist | 3837 Beauvista Dr, Charlotte, NC 28269-1090 | 2019-06-22 |
| 1669944427 | Monique Moreno Aquino | Marriage & Family Therapist | 1118 Skyview Rd, Charlotte, NC 28208-6249 | 2018-12-18 |
| Find all providers in CHARLOTTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.