Individual
AMANDA WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
57 W 57TH ST STE 1101, NEW YORK, NY 10019-2814
(800) 381-7340
Mailing address
279 E 44TH ST APT 15C, NEW YORK, NY 10017-4353
(646) 853-2445
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
1041C0700X
Clinical Social Worker
Primary
102333
NY
Other
Enumeration date
10/06/2020
Last updated
03/05/2026
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