Provider Demographics
NPI:1033667290
Name:RIENDEAU, AMANDA (LICSW-S)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:RIENDEAU
Suffix:
Gender:F
Credentials:LICSW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1955 RIDEOUT DR NW STE 400
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-1673
Mailing Address - Country:US
Mailing Address - Phone:256-212-0567
Mailing Address - Fax:
Practice Address - Street 1:1955 RIDEOUT DR NW STE 400
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-1673
Practice Address - Country:US
Practice Address - Phone:256-212-0567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-16
Last Update Date:2024-12-12
Deactivation Date:2020-03-19
Deactivation Code:
Reactivation Date:2023-06-23
Provider Licenses
StateLicense IDTaxonomies
225C00000X
AL5353C-S1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor