Provider Demographics
NPI:1407359987
Name:KOZLOWSKI, AMANDA (LCSW, CADC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:KOZLOWSKI
Suffix:
Gender:F
Credentials:LCSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5805 OAKWOOD DR APT B
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-2932
Mailing Address - Country:US
Mailing Address - Phone:630-335-4209
Mailing Address - Fax:
Practice Address - Street 1:477 E BUTTERFIELD RD STE 212
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-4879
Practice Address - Country:US
Practice Address - Phone:630-335-4209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-12
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker