Provider Demographics
NPI:1124368246
Name:FLOOD, AMANDA (LICSW)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:FLOOD
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 MASON ST UNIT 4
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-2265
Mailing Address - Country:US
Mailing Address - Phone:978-744-1585
Mailing Address - Fax:
Practice Address - Street 1:41 MASON ST UNIT 4
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2265
Practice Address - Country:US
Practice Address - Phone:978-744-1585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-26
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1139571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical