Provider Demographics
NPI:1811675416
Name:MCKONE, AMANDA LENA (LCSWA)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:LENA
Last Name:MCKONE
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:LENA
Other - Last Name:MOHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSWA
Mailing Address - Street 1:4936 ELM HEIGHTS LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-4643
Mailing Address - Country:US
Mailing Address - Phone:919-449-4288
Mailing Address - Fax:
Practice Address - Street 1:3755 BENSON DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7386
Practice Address - Country:US
Practice Address - Phone:919-449-4288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-05
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0192911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1528563194OtherTHREE OAKS BEHAVIORAL HEALTH & WELLNESS
NCP019291OtherLICENSED CLINICAL SOCIAL WORKER ASSOCIATE