Provider Demographics
NPI:1669955522
Name:RIPLEY, AMANDA KATE (LMSW, CASAC-T)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:KATE
Last Name:RIPLEY
Suffix:
Gender:F
Credentials:LMSW, CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 HEGEMAN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-4764
Mailing Address - Country:US
Mailing Address - Phone:347-390-7052
Mailing Address - Fax:
Practice Address - Street 1:39 HEGEMAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-4764
Practice Address - Country:US
Practice Address - Phone:347-390-7052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-07
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1006551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical