Provider Demographics
NPI:1245388578
Name:SPINDEL, AMY RENEE (LCSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:RENEE
Last Name:SPINDEL
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 1:4533 VISTA KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-3354
Mailing Address - Country:US
Mailing Address - Phone:617-721-5194
Mailing Address - Fax:
Practice Address - Street 1:4533 VISTA KNOLL DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-3354
Practice Address - Country:US
Practice Address - Phone:972-734-5176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X
MA1147681041C0700X
MA213890104100000X
TX534191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB120190Medicare PIN