Provider Demographics
NPI:1578053211
Name:SCEPUREK, AMANDA LEE (LMSW)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:LEE
Last Name:SCEPUREK
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 1:1820 THE EXCHANGE SE STE 550
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-2088
Mailing Address - Country:US
Mailing Address - Phone:630-460-0519
Mailing Address - Fax:
Practice Address - Street 1:413 56TH ST
Practice Address - Street 2:
Practice Address - City:CLARENDON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60514-1505
Practice Address - Country:US
Practice Address - Phone:630-460-0519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-17
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL17-40218106S00000X
GAMSW0101761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician