Provider Demographics
NPI:1558951251
Name:ZENO, AMANDA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:ZENO
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 1:145 RESERVOIR RD
Mailing Address - Street 2:
Mailing Address - City:FORT EDWARD
Mailing Address - State:NY
Mailing Address - Zip Code:12828-2406
Mailing Address - Country:US
Mailing Address - Phone:518-791-1563
Mailing Address - Fax:
Practice Address - Street 1:551 BAY RD STE 2
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-3008
Practice Address - Country:US
Practice Address - Phone:518-410-4827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY082866104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker