Provider Demographics
NPI:1568939817
Name:CONNOR, AMANDA MARIE (LMSW)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARIE
Last Name:CONNOR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 W NORTH MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:MO
Mailing Address - Zip Code:64085-1743
Mailing Address - Country:US
Mailing Address - Phone:816-470-6300
Mailing Address - Fax:816-470-6301
Practice Address - Street 1:108 W NORTH MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:MO
Practice Address - Zip Code:64085-1743
Practice Address - Country:US
Practice Address - Phone:816-470-6300
Practice Address - Fax:816-470-6301
Is Sole Proprietor?:No
Enumeration Date:2018-10-25
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2016018136104100000X
MO20160118136104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker