Provider Demographics
NPI:1063013662
Name:LESTER, AMANDA (MSW, LMSW)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:LESTER
Suffix:
Gender:F
Credentials:MSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 QUARRIER ST STE 310
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-2338
Mailing Address - Country:US
Mailing Address - Phone:304-513-3900
Mailing Address - Fax:
Practice Address - Street 1:1400 OHIO AVE STE A
Practice Address - Street 2:
Practice Address - City:DUNBAR
Practice Address - State:WV
Practice Address - Zip Code:25064-2935
Practice Address - Country:US
Practice Address - Phone:304-205-7978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-02
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
WVSW062216266104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator