Provider Demographics
NPI:1871162370
Name:SEPE, AMANDA G (MSW)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:G
Last Name:SEPE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 CENTRAL AVE BUILDING 10 APT 302
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02861
Mailing Address - Country:US
Mailing Address - Phone:401-662-6491
Mailing Address - Fax:
Practice Address - Street 1:520 HOPE ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-2599
Practice Address - Country:US
Practice Address - Phone:401-276-4152
Practice Address - Fax:401-276-4571
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-21
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker