Provider Demographics
NPI:1962998898
Name:SIFONTE, AMANDA (LCSW, MA, CASAC)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:SIFONTE
Suffix:
Gender:F
Credentials:LCSW, MA, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5680 BROADWAY # 1070
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-4110
Mailing Address - Country:US
Mailing Address - Phone:646-632-2801
Mailing Address - Fax:
Practice Address - Street 1:5680 BROADWAY # 1070
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-4110
Practice Address - Country:US
Practice Address - Phone:646-632-2801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-03
Last Update Date:2025-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0947161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical