Provider Demographics
NPI:1962293290
Name:RETZER, AMANDA (MSW, LSW, CADC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:RETZER
Suffix:
Gender:F
Credentials:MSW, LSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 S RIVER ST UNIT 306
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-6075
Mailing Address - Country:US
Mailing Address - Phone:224-595-6419
Mailing Address - Fax:
Practice Address - Street 1:1952 MCDOWELL RD #305
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563
Practice Address - Country:US
Practice Address - Phone:630-689-1022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150113864104100000X
IL38899101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)