MEDICARE: AMANDA STEFFON 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
1	1041C0700X	Clinical Social Worker	7748904-3501	UT

General Provider Information

NPI Number	:	1154172757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA STEFFON LCSW

Provider Business Mailing Address
First Line	:	5948 W JUNIPER ACRES CT
Second Line	:
City	:	WEST VALLEY
State	:	UT
Zip	:	84128-4609
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	333 W 1425 N
Second Line	:
City	:	CEDAR CITY
State	:	UT
Zip	:	84721-8872
Country	:	US
Telephone Number	:	435-267-1700
Fax Number	:

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

Provider Enumeration Date	:	04/01/2024
Last Update Date	:	04/01/2024

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