Provider Demographics
NPI:1821976101
Name:AMANDA LOSITO LLC
Entity type:Organization
Organization Name:AMANDA LOSITO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOSITO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-477-4082
Mailing Address - Street 1:2383 AKERS MILL RD SE APT F17
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-2511
Mailing Address - Country:US
Mailing Address - Phone:404-477-4082
Mailing Address - Fax:
Practice Address - Street 1:317 W HILL ST STE 204A
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-4367
Practice Address - Country:US
Practice Address - Phone:404-477-4082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health