Provider Demographics
NPI:1700086832
Name:KATZ, AMANDA PAIGE (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:PAIGE
Last Name:KATZ
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:PAIGE
Other - Last Name:BOBROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:39 COMMONWEALTH AVE
Mailing Address - Street 2:APT. 22
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-1064
Mailing Address - Country:US
Mailing Address - Phone:917-533-0198
Mailing Address - Fax:
Practice Address - Street 1:30 WARREN ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3602
Practice Address - Country:US
Practice Address - Phone:617-254-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1139901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical