Provider Demographics
NPI:1972171049
Name:POUNCY-ROSS, AMANDA LYNN (LCSW)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LYNN
Last Name:POUNCY-ROSS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:LYNN
Other - Last Name:ALTUM-POUNCY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2028 E BEN WHITE BLVD STE 240-1847
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78741-6966
Mailing Address - Country:US
Mailing Address - Phone:512-580-7329
Mailing Address - Fax:512-503-8260
Practice Address - Street 1:2028 E BEN WHITE BLVD STE 240-1847
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78741-6966
Practice Address - Country:US
Practice Address - Phone:512-580-7329
Practice Address - Fax:512-503-8260
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-15
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1046341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical