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General NPI Number Information
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NPI Number | 1225945843
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Entity Type | Individual
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Provider Name | AMANDA STEPHENSON
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Gender | Female
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Dates
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Enumeration Date | 08/27/2026
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Last Update Date | 08/27/2026
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Provider Practice Location Address
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Address Line | 100 WRIGHT CT NE
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City | CALHOUN
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State | GA
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Zip | 30701-4779
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Country | US
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Telephone | 706-659-7664
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Fax |
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Provider Business Mailing Address
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Address Line | 13279 FAIRMOUNT HWY SE
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City | FAIRMOUNT
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State | GA
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Zip | 30139-2411
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Country | US
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Telephone | 706-537-4488
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | CSW010596
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License Number State | GA
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