Individual
MS. AMANDA BRECHKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-R
Contact information
Practice address
217 CREST STREET, VESTAL, NY 13850
(315) 796-7484
Mailing address
217 CREST STREET, VESTAL, NY 13850
(315) 796-7484
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
082362
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00618162
GROUP MEDICAID NUMBER
NY
01
—
39062A
GROUP MEDICARE NUMBER
—
Enumeration date
09/15/2010
Last updated
07/26/2021
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