Provider Demographics
NPI:1508966797
Name:MCMANN, AMY ELIZABETH (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:ELIZABETH
Last Name:MCMANN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 KILDAIRE FARM RD STE 200
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-4587
Mailing Address - Country:US
Mailing Address - Phone:919-257-9634
Mailing Address - Fax:919-450-0344
Practice Address - Street 1:1135 KILDAIRE FARM RD STE 200
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511
Practice Address - Country:US
Practice Address - Phone:919-257-9634
Practice Address - Fax:919-450-0344
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2020-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0041821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6002685Medicaid
NC2173126OtherCIGNA BEHAVORIAL HEALTH
NC7909501OtherAETNA
NC132JYOtherBCBSNC