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Amanda Collette Dziadosz

Social Worker

Behavioral Health & Social Service Providers

8 Cadillac Dr, Ste 410, Brentwood, TN 37027

PECOS Enrollment

Based on the most recent information from CMS, provider Amanda Collette Dziadosz does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 11:54 AM.

Profile Details

Provider ID
1396987285
Provider Type
Individual
Full Name
Dziadosz, Amanda Collette
Credential
LCSW, CAADC, SSW

Gender
Female
Sole Proprietor
Yes
Enumeration Date
3/24/2009
Last Updated
1/2/2014

Contact Information

Practice Location

8 Cadillac Dr, Ste 410, Brentwood, TN 37027

(615) 493-8959

Unlisted Fax

Mailing Location

8 Cadillac Dr, Ste 410, Brentwood, TN 37027

(615) 493-8959

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 5680 Tennessee
Code 1041C0700X	Description Social Worker Behavioral Health & Social Service Providers	License 6801085968 Michigan
Code 1041S0200X	Description Social Worker Behavioral Health & Social Service Providers	License 000591153 Tennessee
Code 101YA0400X	Description Counselor Behavioral Health & Social Service Providers	License 200876 Michigan

Amanda Collette Dziadosz

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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