Healthcare Provider Details

I. General information

NPI: 1679105290
Provider Name (Legal Business Name): AMANDA CALNAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2020
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 WILSON BLVD STE 705
ARLINGTON VA
22201-5435
US

IV. Provider business mailing address

2300 WILSON BLVD STE 705
ARLINGTON VA
22201-5435
US

V. Phone/Fax

Practice location:
  • Phone: 808-746-7162
  • Fax: 808-204-8394
Mailing address:
  • Phone: 808-746-7162
  • Fax: 808-204-8394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-5043
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904016211
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: