Amanda Icenhower, MSW, LCSW

NPI #1265895767 in White City, Oregon

Provider Information

NPI Number: 1265895767
Entity Type: Individual
Name: Amanda Icenhower, MSW, LCSW
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker
Credential: MSW, LCSW
Enumeration Date: Apr 1, 2016
Last Updated: Apr 2, 2018

Practice Location

Address: 8495 CRATER LAKE HWY
Address 2: 11CM
City: White City
State: Oregon
ZIP Code: 97503-3011
Phone: (541) 826-2111

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X
Social Worker	104100000X	Primary

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