Provider Demographics
NPI:1639490741
Name:SAND, AMANDA J (LCSW)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:J
Last Name:SAND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:J
Other - Last Name:LICHTEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:124 AMERICAN LEGION DR
Mailing Address - Street 2:
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247-3942
Mailing Address - Country:US
Mailing Address - Phone:413-499-0412
Mailing Address - Fax:
Practice Address - Street 1:124 AMERICAN LEGION DR
Practice Address - Street 2:
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-3942
Practice Address - Country:US
Practice Address - Phone:413-499-0412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-13
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA226372101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health