Individual provider · NPI-1

Amy Bondurant, LCSW

Social Worker, Clinical · Crestview, FL

NPI number1396547170
StatusActive
Last updated in NPPESMar 25, 2025

Details

NPI
1396547170
Entity type
Individual (NPI-1)
Name
Amy Bondurant
Credential
LCSW
Sex
Female
Sole proprietor
No
Enumeration date
Mar 25, 2025
Certification date
Mar 25, 2025
Last updated
Mar 25, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical1396547170FLYes
1041C0700X Social Worker, Clinical––

Practice location

824 N Ferdon Blvd
Crestview, FL 32536-2157

Phone 850-603-0941

Mailing address

824 N Ferdon Blvd
Crestview, FL 32536-2157

Phone 850-603-0941

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Social Worker, Clinical providers in Crestview, FL