Individual
AMANDA LEACH JUSTICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
3701 LANSDOWNE DRIVE, ASHLAND, KY 41102
(606) 324-3005
(606) 329-1530
Mailing address
P.O. BOX 790, ASHLAND, KY 41105-0790
(606) 329-8588
(606) 329-8195
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1473
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12470590
CAQH
—
05
—
7100280860
—
KY
01
—
APPROVED
CIGNA
—
Enumeration date
09/05/2012
Last updated
11/07/2014
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