Healthcare Provider Details

I. General information

NPI: 1699328179
Provider Name (Legal Business Name): AMANDA DODSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2019
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3230 E WOODMEN RD STE 110
COLORADO SPRINGS CO
80920-8502
US

IV. Provider business mailing address

2417 E SAN MIGUEL ST
COLORADO SPRINGS CO
80909-3911
US

V. Phone/Fax

Practice location:
  • Phone: 719-623-2356
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09929143
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: