Individual
AMANDA MAE CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
506 N MAIN ST, NICHOLASVILLE, KY 40356-1134
(513) 834-7063
(513) 873-1567
Mailing address
615 ELSINORE PL STE 200, CINCINNATI, OH 45202-1459
(513) 834-7063
(513) 873-1567
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
165010
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100703950
—
KY
Enumeration date
05/19/2011
Last updated
03/05/2021
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