Provider Demographics
NPI:1093476822
Name:FERRELL, AMANDA RUTH (LCMHC-A, LCAS-A)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:RUTH
Last Name:FERRELL
Suffix:
Gender:F
Credentials:LCMHC-A, LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 BRYANT COMBS RD
Mailing Address - Street 2:
Mailing Address - City:SUGAR GROVE
Mailing Address - State:NC
Mailing Address - Zip Code:28679-9202
Mailing Address - Country:US
Mailing Address - Phone:828-616-9506
Mailing Address - Fax:
Practice Address - Street 1:100 D A R DRIVE
Practice Address - Street 2:
Practice Address - City:CROSSNORE
Practice Address - State:NC
Practice Address - Zip Code:28616
Practice Address - Country:US
Practice Address - Phone:828-733-4305
Practice Address - Fax:336-728-4355
Is Sole Proprietor?:No
Enumeration Date:2022-01-04
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA16819101YP2500X
NC29460101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)