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General NPI Number Information
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NPI Number | 1386537611
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Entity Type | Individual
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Provider Name | AMANDA KATHLEEN BILLUPS LMSW
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Gender | Female
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Dates
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Enumeration Date | 06/03/2025
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 144 CHURCH ST NW STE 205
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City | VIENNA
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State | VA
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Zip | 22180-4550
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Country | US
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Telephone | 571-261-7764
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Fax |
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Provider Business Mailing Address
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Address Line | 628 LEGACY PRIDE DR
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City | HERNDON
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State | VA
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Zip | 20170-5032
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Country | US
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Telephone | 501-352-6797
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 0903004528
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License Number State | VA
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