Provider Demographics
NPI:1033633961
Name:MENSAH, AMANDA M (MSW, LISW)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:M
Last Name:MENSAH
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3029 KOLA WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-3288
Mailing Address - Country:US
Mailing Address - Phone:614-949-8946
Mailing Address - Fax:
Practice Address - Street 1:438 E WILSON BRIDGE RD STE 203
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2382
Practice Address - Country:US
Practice Address - Phone:614-354-4822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.23047621041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical