Provider Demographics
NPI:1427390566
Name:DUNCAN, AMANDA LONG (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:LONG
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 NORTH AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CLEVELAND
Mailing Address - State:GA
Mailing Address - Zip Code:30528-1397
Mailing Address - Country:US
Mailing Address - Phone:706-348-8674
Mailing Address - Fax:
Practice Address - Street 1:42 NORTH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:CLEVELAND
Practice Address - State:GA
Practice Address - Zip Code:30528-1397
Practice Address - Country:US
Practice Address - Phone:706-348-8674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0048451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical