Provider Demographics
NPI:1447794771
Name:ROZYCKI, AMANDA JANNEY (LCSWA)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:JANNEY
Last Name:ROZYCKI
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 W MAIN ST STE 22
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-2076
Mailing Address - Country:US
Mailing Address - Phone:919-491-1886
Mailing Address - Fax:
Practice Address - Street 1:2608 ERWIN RD STE 300
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4597
Practice Address - Country:US
Practice Address - Phone:919-491-1886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0085261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical