MEDICARE: AMANDA BACKUS

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	:	1619822715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA BACKUS

Provider Business Mailing Address
First Line	:	2301 ROSS ST UNIT 31222
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79120-4450
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2301 ROSS ST UNIT 31222
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79120-4450
Country	:	US
Telephone Number	:	806-464-4814
Fax Number	:

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

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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Directions to “ AMANDA BACKUS ” Practice Location

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