Healthcare Provider Details

I. General information

NPI: 1871959619
Provider Name (Legal Business Name): AMANDA LYNN ACREE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2016
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1540 E EVERGREEN ST
SPRINGFIELD MO
65803-4300
US

IV. Provider business mailing address

1540 E EVERGREEN ST
SPRINGFIELD MO
65803-4300
US

V. Phone/Fax

Practice location:
  • Phone: 417-823-2900
  • Fax: 417-823-2981
Mailing address:
  • Phone: 417-823-2900
  • Fax: 417-823-2981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2013042279
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: