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NPI Code Detail

MEDICARE: AMANDA L FOREVER LCSW

MEDICARE: AMANDA L FOREVER LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1003492331
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA L FOREVER LCSW
Provider Business Mailing Address
First Line : W175N11120 STONEWOOD DR
Second Line :
City : GERMANTOWN
State : WI
Zip : 53022-4799
Country : US
Telephone Number : 800-438-1772
Fax Number : 262-345-5562
Provider Business Practice Location Address
First Line : W175N11120 STONEWOOD DR
Second Line :
City : GERMANTOWN
State : WI
Zip : 53022-4799
Country : US
Telephone Number : 800-438-1772
Fax Number : 262-345-5562
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2021
Last Update Date : 09/10/2025

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Directions to “ AMANDA L FOREVER LCSW” Practice Location

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