IndividualActive
Amanda Gannon, LMSW
NPI 1285234419 · Mental Health Counselor · Ketchikan, AK
Provider details
- NPI number
- 1285234419
- Entity type
- Individual
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Credential
- LMSW
- Sex
- Female
- Sole proprietor
- No
- License
- 215055 (AK)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Practice location
344 Front St Ste a
Ketchikan, AK 99901-6431
Phone: (572) 999-0107
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 519
Ward Cove, AK 99928-0519
Registry dates
- Enumerated
- 2020-10-27
- Last updated
- 2024-08-01
- Certified
- 2024-08-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.