Provider Demographics
NPI:1023378288
Name:GARRICK, AMANDA CHRISTINE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:CHRISTINE
Last Name:GARRICK
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 1:140 LINDEN AVE
Mailing Address - Street 2:603
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-4958
Mailing Address - Country:US
Mailing Address - Phone:562-544-9474
Mailing Address - Fax:
Practice Address - Street 1:140 LINDEN AVE
Practice Address - Street 2:603
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-4958
Practice Address - Country:US
Practice Address - Phone:562-544-9474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA226881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical