| Amanda Lois Creel Banta, LICSW | |
|
517 Energy Center Blvd Ste 1302, Northport, AL 35473-5810 | |
| (205) 553-9171 | |
| (334) 218-5815 |
| Full Name | Amanda Lois Creel Banta |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 517 Energy Center Blvd Ste 1302, Northport, Alabama |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942065909 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 5110C-S (Alabama) | Primary |
| Entity Name | Amh Enterprises Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588229843 PECOS PAC ID: 1153651666 Enrollment ID: O20190926001366 |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Lois Creel Banta, LICSW 517 Energy Center Blvd Ste 1302, Northport, AL 35473-5810 Ph: (205) 532-7387 | Amanda Lois Creel Banta, LICSW 517 Energy Center Blvd Ste 1302, Northport, AL 35473-5810 Ph: (205) 553-9171 |
Ms. Shelly Lynn Edwards, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1333 Wrens Nest Way, Northport, AL 35476 Phone: 406-431-7288 | |
Vanessa Graves, LICSW, PIP Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 521 Energy Center Blvd Ste 1506, Northport, AL 35473 Phone: 205-737-7678 Fax: 205-737-7681 | |
Paloma K Castillo, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4124 Watermelon Rd, Northport, AL 35473 Phone: 205-454-1897 | |
Donna Rae Jones, LCSW PTP Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 505 Energy Center Blvd, Suite 605, Northport, AL 35473 Phone: 205-469-2043 | |
Kiana Winston, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4244 Mcfarland Blvd, Northport, AL 35476 Phone: 833-484-2878 | |
Ms. Katie Reich, LCSW BCD Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 519 Energy Center Blvd Ste 1105, Northport, AL 35473 Phone: 205-248-2255 Fax: 205-248-7321 | |
Mrs. Rachel D Lathrop, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4126 Richmond St, Northport, AL 35473 Phone: 205-454-5673 |