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Amanda Gabrielle Kacena, LLC

Social Worker, Clinical in Valparaiso, IN. Organization (NPI-2).

NPI number1104337195
StatusActive
Last updated in NPPESOct 17, 2017

Details

NPI
1104337195
Entity type
Organization (NPI-2)
Legal business name
Amanda Gabrielle Kacena, LLC
Organization subpart
No
Enumeration date
Oct 17, 2017
Last updated
Oct 17, 2017

Medicare and OIG

Medicare enrolled (PECOS)
Not in the Medicare enrollment file
Can order and refer
Not on the CMS order and referring list
OIG exclusion list
This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical39001619AINYes

Practice location

2005 Valparaiso St Ste 106
Valparaiso, IN 46383-3330

Phone 312-590-7140

Mailing address

4101 Brentwood Dr
Valparaiso, IN 46383-1373

Phone 312-590-7140

Authorized official

Amanda Gabrielle Kacena
Owner
3125907140

Is something wrong?

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Other Clinical Social Worker providers in Valparaiso, IN

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