Provider Demographics
NPI:1497290662
Name:FOOKS, AMANDA (LSW)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:FOOKS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-1904
Mailing Address - Country:US
Mailing Address - Phone:717-782-4349
Mailing Address - Fax:717-782-6518
Practice Address - Street 1:401 DIVISION ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-2058
Practice Address - Country:US
Practice Address - Phone:717-782-4349
Practice Address - Fax:717-782-6518
Is Sole Proprietor?:No
Enumeration Date:2016-12-27
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW132773104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker