Provider Demographics
NPI:1700479128
Name:DEGLER, AMANDA BETH (LSW)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:BETH
Last Name:DEGLER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:BETH
Other - Last Name:MCATEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24100 CHAGRIN BLVD STE 125
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5535
Mailing Address - Country:US
Mailing Address - Phone:216-714-3278
Mailing Address - Fax:800-879-1741
Practice Address - Street 1:24100 CHAGRIN BLVD STE 125
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5535
Practice Address - Country:US
Practice Address - Phone:216-714-3278
Practice Address - Fax:800-879-1741
Is Sole Proprietor?:No
Enumeration Date:2021-02-17
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2105917104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker