Provider Demographics
NPI:1942583802
Name:MARCONI, AMANDA ELIZABETH (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:AMANDA
Middle Name:ELIZABETH
Last Name:MARCONI
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 1:2821 S PARKER RD STE 405
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-2748
Mailing Address - Country:US
Mailing Address - Phone:720-372-3644
Mailing Address - Fax:
Practice Address - Street 1:2821 S PARKER RD STE 405
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2748
Practice Address - Country:US
Practice Address - Phone:720-372-3644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-27
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO099238491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO80537031Medicaid