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Individual

AMANDA LEWELLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW, LCSW

Contact information

Practice address
308 MEDIC WAY, GREENCASTLE, IN 46135-2296
(765) 653-2669
Mailing address
12269 STATE HIGHWAY 243, CLOVERDALE, IN 46120-8019

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34005429A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000552508
ANTHEM BCBS
IN
Enumeration date
05/18/2006
Last updated
04/14/2008
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