Provider Demographics
NPI:1548835291
Name:UPTHEGROVE, AMANDA MAY (LCSW)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:MAY
Last Name:UPTHEGROVE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9397 CROWN CREST BLVD STE 440
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-8789
Mailing Address - Country:US
Mailing Address - Phone:970-310-3406
Mailing Address - Fax:
Practice Address - Street 1:9403 CROWN CREST BLVD STE 200
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-8991
Practice Address - Country:US
Practice Address - Phone:303-840-8780
Practice Address - Fax:303-840-8795
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
CO099272481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical