Provider Demographics
NPI:1427593946
Name:SPIEGEL, AMANDA JANE (LCSW)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:JANE
Last Name:SPIEGEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 SE HAMBY LN
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64477-1608
Mailing Address - Country:US
Mailing Address - Phone:816-392-7059
Mailing Address - Fax:
Practice Address - Street 1:505 SE HAMBY LN
Practice Address - Street 2:
Practice Address - City:PLATTSBURG
Practice Address - State:MO
Practice Address - Zip Code:64477-1608
Practice Address - Country:US
Practice Address - Phone:816-392-7059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-20
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS8274104100000X
MO20150278611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker