Provider Demographics
NPI:1720218969
Name:AMANTE, ANITA (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:
Last Name:AMANTE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MISS
Other - First Name:ANITA
Other - Middle Name:
Other - Last Name:TOSADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:47 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:WEST BOYLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:01583-1301
Mailing Address - Country:US
Mailing Address - Phone:508-709-5513
Mailing Address - Fax:
Practice Address - Street 1:47 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:WEST BOYLSTON
Practice Address - State:MA
Practice Address - Zip Code:01583-1301
Practice Address - Country:US
Practice Address - Phone:508-709-5513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-22
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical