Provider Demographics
NPI:1164868519
Name:SYMMES, AMANDA C (LICSW)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:C
Last Name:SYMMES
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 1:4 HOOD RD
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-2202
Mailing Address - Country:US
Mailing Address - Phone:978-766-6041
Mailing Address - Fax:978-535-2907
Practice Address - Street 1:93 MAIN ST STE 131
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-3847
Practice Address - Country:US
Practice Address - Phone:978-766-6041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-13
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MA120861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor