Provider Demographics
NPI:1982820262
Name:MCGANN, AMANDA JEAN (BA)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:JEAN
Last Name:MCGANN
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2228 126TH ST
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:COLLEGE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11356-2634
Mailing Address - Country:US
Mailing Address - Phone:347-368-6799
Mailing Address - Fax:
Practice Address - Street 1:3722 82ND ST
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7032
Practice Address - Country:US
Practice Address - Phone:718-779-1600
Practice Address - Fax:718-396-6189
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor