Provider Demographics
NPI:1467134593
Name:AMADI, DECLAN TOCHI (MSW)
Entity Type:Individual
Prefix:MR
First Name:DECLAN
Middle Name:TOCHI
Last Name:AMADI
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1827 W GOWAN ROAD
Mailing Address - Street 2:UNIT 2178
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032
Mailing Address - Country:US
Mailing Address - Phone:952-219-2177
Mailing Address - Fax:
Practice Address - Street 1:2578 BROADWAY
Practice Address - Street 2:UNIT 607
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025
Practice Address - Country:US
Practice Address - Phone:516-847-5432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN319541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical