Provider Demographics
NPI:1154171072
Name:SALDANA, AMANDA MEGAN ROSE (LCSW)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:MEGAN ROSE
Last Name:SALDANA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2736 PENNYROYAL CIR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-4377
Mailing Address - Country:US
Mailing Address - Phone:312-618-1902
Mailing Address - Fax:
Practice Address - Street 1:2736 PENNYROYAL CIR
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-4377
Practice Address - Country:US
Practice Address - Phone:312-618-1902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0266941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical