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General NPI Number Information
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NPI Number | 1144942418
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Entity Type | Organization
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Legal Business Name | AMANDA IVES LCSW PLLC
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Dates
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Enumeration Date | 09/14/2022
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 727 DOBSON ST APT 1
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City | EVANSTON
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State | IL
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Zip | 60202-5253
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Country | US
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Telephone | 312-402-2460
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Fax | 224-714-0972
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Provider Business Mailing Address
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Address Line | 727 DOBSON ST APT 1
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City | EVANSTON
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State | IL
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Zip | 60202-5253
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Country | US
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Telephone | 312-402-2460
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Fax | 262-586-6704
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Authorized Official
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Title or Position | OWNER
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Name | AMANDA IVES
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Credential | LCSW
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Telephone | 312-402-2460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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