Provider Demographics
NPI:1518664390
Name:MAGUIRE, AMANDA L (LCSW)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:L
Last Name:MAGUIRE
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 1:468 SPIRIT RANCH RD
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CO
Mailing Address - Zip Code:80536-9242
Mailing Address - Country:US
Mailing Address - Phone:970-473-2801
Mailing Address - Fax:
Practice Address - Street 1:468 SPIRIT RANCH RD
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CO
Practice Address - Zip Code:80536-9242
Practice Address - Country:US
Practice Address - Phone:970-473-2801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099249961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical