Provider Demographics
NPI:1174672620
Name:HIGH, AMANDA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:HIGH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:SIMS-HIGH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:655 SOUTH 7TH STREET BLDG 700
Mailing Address - Street 2:78 MDG/SGOW-F
Mailing Address - City:ROBINS AFB
Mailing Address - State:GA
Mailing Address - Zip Code:31098-2227
Mailing Address - Country:US
Mailing Address - Phone:478-327-8402
Mailing Address - Fax:
Practice Address - Street 1:655 SOUTH 7TH STREET BLDG 700
Practice Address - Street 2:78 MDG/SGOW-F
Practice Address - City:ROBINS AFB
Practice Address - State:GA
Practice Address - Zip Code:31098-2227
Practice Address - Country:US
Practice Address - Phone:478-327-8402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW004188104100000X
CO20181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker