Provider Demographics
NPI:1255710281
Name:AMANDA BARNETT, LCSW, INC
Entity type:Organization
Organization Name:AMANDA BARNETT, LCSW, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:818-754-4644
Mailing Address - Street 1:20720 VENTURA BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364
Mailing Address - Country:US
Mailing Address - Phone:818-754-4644
Mailing Address - Fax:818-587-3353
Practice Address - Street 1:20720 VENTURA BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2306
Practice Address - Country:US
Practice Address - Phone:818-754-4644
Practice Address - Fax:818-587-3353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-22
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS18037251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health