Provider Demographics
NPI:1568915924
Name:MCCLAIN, AMANDA (LMSW)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:CAMIELLE
Other - Last Name:BROOKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1820 MEMORIAL CIR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-4539
Mailing Address - Country:US
Mailing Address - Phone:931-920-7356
Mailing Address - Fax:931-920-7205
Practice Address - Street 1:1820 MEMORIAL CIR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-4539
Practice Address - Country:US
Practice Address - Phone:931-920-7356
Practice Address - Fax:931-920-7205
Is Sole Proprietor?:No
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000080391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical