Provider Demographics
NPI:1427687920
Name:MORALES, AMANDA (LCSW-C)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:FORTIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7822 EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-2115
Mailing Address - Country:US
Mailing Address - Phone:443-808-1686
Mailing Address - Fax:
Practice Address - Street 1:7822 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-2115
Practice Address - Country:US
Practice Address - Phone:443-808-1686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-06
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD281391041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical