Provider Demographics
NPI:1184211203
Name:STEM, AMANDA (LCSW, LCAS)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:STEM
Suffix:
Gender:F
Credentials:LCSW, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 OLD TOLL RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-3723
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19 ZILLICOA ST STE 3
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-1063
Practice Address - Country:US
Practice Address - Phone:828-333-4907
Practice Address - Fax:828-412-3257
Is Sole Proprietor?:No
Enumeration Date:2020-12-22
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0128091041C0700X
NCC0138521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical