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NPI Code Detail

MEDICARE: AMANDA BURGOS LSW

MEDICARE: AMANDA BURGOS LSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLMSW-22258AZ
21041C0700XClinical Social Worker149.030830IL
31041C0700XClinical Social Worker150.112993IL

General Provider Information

NPI Number : 1164288601
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA BURGOS LSW
Provider Business Mailing Address
First Line : 7353 S GIACHERY AVE
Second Line :
City : TUCSON
State : AZ
Zip : 85747-5611
Country : US
Telephone Number : 520-268-1330
Fax Number :
Provider Business Practice Location Address
First Line : 3601 S 6TH AVE
Second Line :
City : TUCSON
State : AZ
Zip : 85723-0001
Country : US
Telephone Number : 520-268-1330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2024
Last Update Date : 01/13/2026

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Directions to “ AMANDA BURGOS LSW” Practice Location

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