Provider Demographics
NPI:1194566729
Name:FRITZ, AMANDA (LMSW)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:FRITZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 S RAISINVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-9047
Mailing Address - Country:US
Mailing Address - Phone:734-288-8161
Mailing Address - Fax:
Practice Address - Street 1:100 MAPLE ST STE 215
Practice Address - Street 2:
Practice Address - City:WYANDOTTE
Practice Address - State:MI
Practice Address - Zip Code:48192-5966
Practice Address - Country:US
Practice Address - Phone:734-288-8161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical