Provider Demographics
NPI:1346226628
Name:CURTIN, AMANDA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:CURTIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:
Other - Last Name:EDGERLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11 BELLIS CIR
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-3207
Mailing Address - Country:US
Mailing Address - Phone:617-864-1875
Mailing Address - Fax:617-864-2552
Practice Address - Street 1:11 BELLIS CIR
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-3207
Practice Address - Country:US
Practice Address - Phone:617-864-1875
Practice Address - Fax:617-864-2552
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10163071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P04687OtherBLUE CROSS AND BLUE SHIEL
267885OtherMAGELLAN BEHAV HEALTH
267885OtherMAGELLAN BEHAV HEALTH