Provider Demographics
NPI:1689225054
Name:PADGETT, AMANDA KAY (LCSW, LAC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:KAY
Last Name:PADGETT
Suffix:
Gender:F
Credentials:LCSW, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 E 27TH ST
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-3203
Mailing Address - Country:US
Mailing Address - Phone:970-795-2996
Mailing Address - Fax:
Practice Address - Street 1:323 E 27TH ST
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-3203
Practice Address - Country:US
Practice Address - Phone:970-310-3406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-26
Last Update Date:2023-06-22
Deactivation Date:2019-09-26
Deactivation Code:
Reactivation Date:2019-10-03
Provider Licenses
StateLicense IDTaxonomies
COACD.0001791101YA0400X
COCSW.099274851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)