Provider Demographics
NPI:1457718421
Name:JUZA-HAMRICK, AMANDA (LCSW)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:JUZA-HAMRICK
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 1:8114 SW POKEGAMA DR
Mailing Address - Street 2:
Mailing Address - City:POWELL BUTTE
Mailing Address - State:OR
Mailing Address - Zip Code:97753-1564
Mailing Address - Country:US
Mailing Address - Phone:541-668-1692
Mailing Address - Fax:
Practice Address - Street 1:818 SW FOREST AVE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-2737
Practice Address - Country:US
Practice Address - Phone:541-293-3039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-21
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
ORL75901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical