Provider Demographics
NPI:1821411687
Name:MORANTES, AMY ELLEN BROWNE (LCSW-C)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:ELLEN BROWNE
Last Name:MORANTES
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3224 MARCELLUS CIR
Mailing Address - Street 2:SUITE # 622
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-3086
Mailing Address - Country:US
Mailing Address - Phone:240-777-3326
Mailing Address - Fax:240-777-4665
Practice Address - Street 1:1818 E FLETCHER AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-3770
Practice Address - Country:US
Practice Address - Phone:813-971-2383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-30
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD169511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical