Provider Demographics
NPI:1023799426
Name:HOLLINGSWORTH, AMANDA GAIL (LMSW)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:GAIL
Last Name:HOLLINGSWORTH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 EGYPT RD
Mailing Address - Street 2:
Mailing Address - City:BOAZ
Mailing Address - State:AL
Mailing Address - Zip Code:35956-7910
Mailing Address - Country:US
Mailing Address - Phone:256-505-2975
Mailing Address - Fax:
Practice Address - Street 1:623 WALNUT ST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-4136
Practice Address - Country:US
Practice Address - Phone:256-673-4346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6034G1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical