MEDICARE: AMANDA S. CECIL 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	252076	KY

General Provider Information

NPI Number	:	1467906123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA S. CECIL LCSW

Provider Business Mailing Address
First Line	:	600 W EVERLY BROTHERS BLVD STE 304
Second Line	:
City	:	CENTRAL CITY
State	:	KY
Zip	:	42330-1884
Country	:	US
Telephone Number	:	270-903-6099
Fax Number	:	270-698-9778

Provider Business Practice Location Address
First Line	:	600 W EVERLY BROTHERS BLVD
Second Line	:
City	:	CENTRAL CITY
State	:	KY
Zip	:	42330-1884
Country	:	US
Telephone Number	:	270-903-6099
Fax Number	:

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

Provider Enumeration Date	:	08/11/2016
Last Update Date	:	06/22/2023

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