MEDICARE: MRS. AMANDA SWEAT L.M.H.C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH12110	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003244484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMANDA SWEAT L.M.H.C

Provider Business Mailing Address
First Line	:	8465 MERCHANTS WAY STE 206
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32222-2858
Country	:	US
Telephone Number	:	904-247-2322
Fax Number	:

Provider Business Practice Location Address
First Line	:	8465 MERCHANTS WAY STE 206
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32222-2858
Country	:	US
Telephone Number	:	423-206-2299
Fax Number	:	423-717-5594

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2013
Last Update Date	:	11/29/2021

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Directions to “ MRS. AMANDA SWEAT L.M.H.C” Practice Location

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