IndividualActive
Amy Prudencio, LCSW
NPI 1295244242 · School Social Worker · Carbondale, IL
Provider details
- NPI number
- 1295244242
- Entity type
- Individual
- Primary specialty
- School Social WorkerBehavioral Health & Social Service Providers
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- No
- License
- 149014863 (IL)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
1301 E. Walnut Street
Carbondale, IL 62901
Phone: (618) 457-3371
Fax: (618) 549-1608
Approximate (ZIP-level) locationGet directions
Mailing address
1301 E Walnut St
Carbondale, IL 62901-5004
Registry dates
- Enumerated
- 2017-09-21
- Last updated
- 2022-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.