Provider Demographics
NPI:1609612811
Name:LLOYD, AMANDA I (ACMHC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:I
Last Name:LLOYD
Suffix:
Gender:F
Credentials:ACMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:949 E 12400 S STE A2
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-9333
Mailing Address - Country:US
Mailing Address - Phone:385-524-6665
Mailing Address - Fax:
Practice Address - Street 1:949 E 12400 S STE A2
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-9333
Practice Address - Country:US
Practice Address - Phone:385-524-6665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13205948-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health