Provider Demographics
NPI:1174094973
Name:MESSENGER, AMANDA E (LICSW)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:E
Last Name:MESSENGER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 399
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:WV
Mailing Address - Zip Code:26354-0399
Mailing Address - Country:US
Mailing Address - Phone:304-265-0312
Mailing Address - Fax:304-265-0314
Practice Address - Street 1:83 POPLAR ST
Practice Address - Street 2:
Practice Address - City:ROWLESBURG
Practice Address - State:WV
Practice Address - Zip Code:26425-1124
Practice Address - Country:US
Practice Address - Phone:304-454-2421
Practice Address - Fax:304-454-9690
Is Sole Proprietor?:No
Enumeration Date:2018-12-06
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVDP009438091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical