Provider Demographics
NPI:1093364358
Name:SWARTZ, AMANDA TAYLOR (LMHC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:TAYLOR
Last Name:SWARTZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 SWEET AMANDAS WAY
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-1732
Mailing Address - Country:US
Mailing Address - Phone:781-534-8434
Mailing Address - Fax:
Practice Address - Street 1:11 SWEET AMANDAS WAY
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-8109
Practice Address - Country:US
Practice Address - Phone:781-534-8434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-10
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13552101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health