Provider Demographics
NPI:1679009674
Name:CARTAGENA, AMANDA YVETTE (LCSW)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:YVETTE
Last Name:CARTAGENA
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 1:447 BROADWAY FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-2562
Mailing Address - Country:US
Mailing Address - Phone:917-426-7277
Mailing Address - Fax:
Practice Address - Street 1:447 BROADWAY FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-2562
Practice Address - Country:US
Practice Address - Phone:917-426-7277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2024-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY097921104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker