Provider Demographics
NPI:1366807158
Name:MARSH, AMANDA CHRISTINE (LCSW)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:CHRISTINE
Last Name:MARSH
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 1:1401 E GIRARD PL
Mailing Address - Street 2:8277
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-3142
Mailing Address - Country:US
Mailing Address - Phone:720-955-8859
Mailing Address - Fax:
Practice Address - Street 1:3534 S. LINCOLN
Practice Address - Street 2:TITAN BLDG ATTN AMANDA MARSH
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3142
Practice Address - Country:US
Practice Address - Phone:720-955-8859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-21
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099237651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical