Provider Demographics
NPI:1699028852
Name:RANKIN, AMANDA ELLA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:ELLA
Last Name:RANKIN
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 1:1140 N MCLEAN BLVD STE I
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-1782
Mailing Address - Country:US
Mailing Address - Phone:847-695-3680
Mailing Address - Fax:224-856-2829
Practice Address - Street 1:1140 N MCLEAN BLVD STE I
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-1782
Practice Address - Country:US
Practice Address - Phone:847-695-3680
Practice Address - Fax:224-856-2829
Is Sole Proprietor?:No
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0108601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical