Provider Demographics
NPI:1144951617
Name:AMODIO, TAMI (LMSW)
Entity type:Individual
Prefix:
First Name:TAMI
Middle Name:
Last Name:AMODIO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 155
Mailing Address - Street 2:
Mailing Address - City:HAINES FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12436-0155
Mailing Address - Country:US
Mailing Address - Phone:518-929-2385
Mailing Address - Fax:
Practice Address - Street 1:21 GRAND ST
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-5628
Practice Address - Country:US
Practice Address - Phone:518-929-2385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0889171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical