Provider Demographics
NPI:1376143222
Name:CAFFEY, AMANDA F (MSW)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:F
Last Name:CAFFEY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4015 MILL DAM CT
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-7393
Mailing Address - Country:US
Mailing Address - Phone:318-780-0478
Mailing Address - Fax:
Practice Address - Street 1:1950 BLUEGRASS CIR STE 200
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-7364
Practice Address - Country:US
Practice Address - Phone:307-778-2577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
WYLCSW-16291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker