Provider Demographics
NPI:1194998831
Name:MAPP, AMANDA A (LMSW)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:A
Last Name:MAPP
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 1:127 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-2801
Mailing Address - Country:US
Mailing Address - Phone:631-727-4044
Mailing Address - Fax:631-727-6531
Practice Address - Street 1:127 W MAIN ST
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-2801
Practice Address - Country:US
Practice Address - Phone:631-727-4044
Practice Address - Fax:631-727-6531
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY068869-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker