MEDICARE: AMANDA M. KEYS, PHD, LCSW, LLC

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	:	1518834456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMANDA M. KEYS, PHD, LCSW, LLC

Provider Business Mailing Address
First Line	:	4236 N HAVEN ST
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65803-9556
Country	:	US
Telephone Number	:	417-350-9009
Fax Number	:

Provider Business Practice Location Address
First Line	:	4236 N HAVEN ST
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65803-9556
Country	:	US
Telephone Number	:	417-350-9009
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AMANDA M KEYS
Credential	:	LCSW
Telephone Number	:	417-676-6103

Provider Enumeration Date	:	10/23/2025
Last Update Date	:	01/12/2026

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