Provider Demographics
NPI:1033662093
Name:AMANDA J CHANEY MSW LLC
Entity Type:Organization
Organization Name:AMANDA J CHANEY MSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHANEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:720-235-5393
Mailing Address - Street 1:6650 S VINE ST STE 215
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80121-2763
Mailing Address - Country:US
Mailing Address - Phone:720-235-5393
Mailing Address - Fax:
Practice Address - Street 1:6650 S VINE ST STE 215
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80121-2763
Practice Address - Country:US
Practice Address - Phone:720-235-5393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-26
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099242961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty