MEDICARE: MARISSA LYNN AMATO

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
1	171M00000X	Case Manager/Care Coordinator
2	1041C0700X	Clinical Social Worker	BBH-SWLC-LIC-64596	MT

General Provider Information

NPI Number	:	1073357646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISSA LYNN AMATO

Provider Business Mailing Address
First Line	:	218 11TH AVE SW
Second Line	:
City	:	SIDNEY
State	:	MT
Zip	:	59270-3608
Country	:	US
Telephone Number	:	406-781-9909
Fax Number	:

Provider Business Practice Location Address
First Line	:	218 11TH AVE SW
Second Line	:
City	:	SIDNEY
State	:	MT
Zip	:	59270-3608
Country	:	US
Telephone Number	:	406-781-9909
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2024
Last Update Date	:	01/15/2026

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Directions to “ MARISSA LYNN AMATO ” Practice Location

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