Healthcare Provider Details

I. General information

NPI: 1326705245
Provider Name (Legal Business Name): AMANDA K HUTCHINSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2021
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 EUBANK BLVD NE STE D1
ALBUQUERQUE NM
87123-2759
US

IV. Provider business mailing address

413 PENNSYLVANIA ST NE
ALBUQUERQUE NM
87108-2220
US

V. Phone/Fax

Practice location:
  • Phone: 505-364-3030
  • Fax:
Mailing address:
  • Phone: 505-364-3030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWB-2023-0230
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: