Logan, Amanda

Logan, Amanda is an individual health care provider with primary practice located at 1202 Westrac Dr S Suite 400, Fargo ND 58103-2338. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Logan, Amanda can be contacted via phone (107) 280-9545.

Contact Information

Primary practice address
1202 Westrac Dr S Suite 400 Fargo ND 58103-2338
Phone: (107) 280-9545
Fax: (701) 280-9520
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 16371 Minnesota
Behavioral Health & Social Service Providers / Social Worker 104100000X 4408 North Dakota
Behavioral Health & Social Service Providers / Clinical 1041C0700X 4408 North Dakota

Profile Details

NPI number 1609246677
LBN Legal business name Logan, Amanda
Credentials MSW, LICSW
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 2nd, 2015
Last updated Nov 2nd, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1609246677 NPPES
North Dakota MEDICAID 1465561

Popular Providers