Provider Demographics
NPI:1750944054
Name:RAMOS, AMANDA (LCSW, QS, CCM, DSW)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:RAMOS
Suffix:
Gender:F
Credentials:LCSW, QS, CCM, DSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20791 THREE OAKS PKWY UNIT 474
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33929-3623
Mailing Address - Country:US
Mailing Address - Phone:239-297-5713
Mailing Address - Fax:
Practice Address - Street 1:12590 WHITEHALL DR STE 3
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-4680
Practice Address - Country:US
Practice Address - Phone:239-939-9090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-22
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW123141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical