Individual
MRS. AMANDA LYNN OVERACRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
002441
CT
1041C0700X
Clinical Social Worker
C013833
NC
1041C0700X
Clinical Social Worker
Primary
LCSW-42059
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42059
LCSW
ID
01
—
C013833
LCSW
NC
01
—
P014431
LCSW-A
NC
Enumeration date
07/17/2012
Last updated
06/06/2024
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