Provider Demographics
NPI:1447351432
Name:DODD, AMANDA NICOLE (LCSW)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:NICOLE
Last Name:DODD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3651 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-3220
Mailing Address - Country:US
Mailing Address - Phone:916-533-3954
Mailing Address - Fax:
Practice Address - Street 1:2750 SUTTERVILLE RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820
Practice Address - Country:US
Practice Address - Phone:916-452-3981
Practice Address - Fax:916-456-4636
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA257791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical