=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104611847
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMANDA SENTERS BSW LSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/14/2025
-----------------------------------------------------
Last Update Date | 04/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2025 DALE RD
-----------------------------------------------------
City | NORWOOD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45212-1047
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-225-9174
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2025 DALE RD
-----------------------------------------------------
City | NORWOOD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45212-1047
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-225-9174
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | S.2410699
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------