Provider Demographics
NPI:1134416910
Name:BARWICK, AMY
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:BARWICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2580 LIN DO CT
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-1832
Mailing Address - Country:US
Mailing Address - Phone:803-905-4427
Mailing Address - Fax:803-905-4431
Practice Address - Street 1:4323 OLD MILL RD STE B
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1117
Practice Address - Country:US
Practice Address - Phone:864-671-1466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1-11-9478103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst