Provider Demographics
NPI:1558777185
Name:SWARTZ, AMY LOUISE (LLPC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LOUISE
Last Name:SWARTZ
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1328 JOSEPH ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-1006
Mailing Address - Country:US
Mailing Address - Phone:517-945-4467
Mailing Address - Fax:
Practice Address - Street 1:1206 CLINTON RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-2005
Practice Address - Country:US
Practice Address - Phone:517-783-4250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011580101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional