Provider Demographics
NPI:1831409309
Name:MAYADENU, AMELIA (LCSW)
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:
Last Name:MAYADENU
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 1:1401 WOOD DUCK DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-1258
Mailing Address - Country:US
Mailing Address - Phone:636-293-4217
Mailing Address - Fax:
Practice Address - Street 1:1401 WOOD DUCK DR
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-1258
Practice Address - Country:US
Practice Address - Phone:636-293-4217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490163411041C0700X
MO20140103041041C0700X
TX1147611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical