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General NPI Number Information
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NPI Number | 1962473801
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Entity Type | Individual
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Provider Name | AMANDA LEE HAWES LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/30/2006
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Last Update Date | 02/18/2015
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Provider Practice Location Address
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Address Line | 8153 WOOD ST SE
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City | COVINGTON
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State | GA
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Zip | 30014-3938
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Country | US
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Telephone | 770-316-9614
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Fax |
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Provider Business Mailing Address
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Address Line | 8153 WOOD ST SE
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City | COVINGTON
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State | GA
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Zip | 30014-3938
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Country | US
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Telephone | 770-316-9614
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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 | MSW003627
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW003996
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License Number State | GA
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