Provider Demographics
NPI:1023451242
Name:COURTER, AMANDA ADAMS (LCSW)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:ADAMS
Last Name:COURTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3615 HARDING AVE
Mailing Address - Street 2:STE 509
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-3757
Mailing Address - Country:US
Mailing Address - Phone:808-739-1992
Mailing Address - Fax:808-739-1995
Practice Address - Street 1:99-128 AIEA HEIGHTS DR
Practice Address - Street 2:STE 305
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-3933
Practice Address - Country:US
Practice Address - Phone:609-214-2011
Practice Address - Fax:212-504-0803
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-08
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI39471041C0700X
HI2026104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI3947OtherLICENSED CLINICAL SOCIAL WORKER
4216112OtherCERTIFIED CASE MANAGER