Provider Demographics
NPI:1851671184
Name:LANNING, AMANDA JO (LMSW)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:JO
Last Name:LANNING
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:JO
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:1830 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:COLBY
Mailing Address - State:KS
Mailing Address - Zip Code:67701-1512
Mailing Address - Country:US
Mailing Address - Phone:785-462-2345
Mailing Address - Fax:
Practice Address - Street 1:485 W 4TH ST
Practice Address - Street 2:
Practice Address - City:COLBY
Practice Address - State:KS
Practice Address - Zip Code:67701-2139
Practice Address - Country:US
Practice Address - Phone:785-460-7588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS8188104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker