Provider Demographics
NPI:1144617671
Name:MEERS, AMANDA C (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:C
Last Name:MEERS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:C
Other - Last Name:EGGERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW-S
Mailing Address - Street 1:60 BRATTLE ST APT 201
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-3737
Mailing Address - Country:US
Mailing Address - Phone:617-240-2742
Mailing Address - Fax:
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-355-9287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-22
Last Update Date:2019-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1450732104100000X
OHI.1700060104100000X
OH1.1700060-SUPV1041C0700X
MA1220911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker