MEDICARE: AMANDA GAUDET LCSW PLLC

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

General Provider Information

NPI Number	:	1235060112
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMANDA GAUDET LCSW PLLC

Provider Business Mailing Address
First Line	:	2810 23RD AVE # 25
Second Line	:
City	:	ASTORIA
State	:	NY
Zip	:	11105-2775
Country	:	US
Telephone Number	:	347-850-0328
Fax Number	:

Provider Business Practice Location Address
First Line	:	2810 23RD AVE # 25
Second Line	:
City	:	ASTORIA
State	:	NY
Zip	:	11105-2775
Country	:	US
Telephone Number	:	347-850-0328
Fax Number	:

Authorized Official
Title or Position	:	MEMBER-MANAGER
Name	:	AMANDA GAUDET
Credential	:	LCSW
Telephone Number	:	978-270-2990

Provider Enumeration Date	:	05/28/2026
Last Update Date	:	05/28/2026

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