Individual provider · NPI-1

Amanda Shanielle Acevedo, LMSW

Social Worker · Islandia, NY

NPI number1942923628
StatusActive
Last updated in NPPESSep 19, 2022

Details

NPI
1942923628
Entity type
Individual (NPI-1)
Name
Ms. Amanda Shanielle Acevedo
Credential
LMSW
Sex
Female
Sole proprietor
No
Enumeration date
Sep 19, 2022
Certification date
Sep 13, 2022
Last updated
Sep 19, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
104100000X Social Worker097228NYYes

Practice location

1777 Veterans Memorial Hwy Ste 14
Islandia, NY 11749-1555

Phone 631-212-2405

Mailing address

15 New York Ave
Bay Shore, NY 11706-3106

Phone 631-398-3122

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