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NPI Code Detail

MEDICARE: AMANDA LYNN ACREE LISW-CP

MEDICARE: AMANDA LYNN ACREE LISW-CP
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
11041C0700XClinical Social Worker2013042279MO
21041C0700XClinical Social Worker18731SC

General Provider Information

NPI Number : 1871959619
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA LYNN ACREE LISW-CP
Provider Business Mailing Address
First Line : 4800 N SCOTTSDALE RD STE 2500
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85251-7630
Country : US
Telephone Number : 843-501-1099
Fax Number : 843-405-2040
Provider Business Practice Location Address
First Line : 871 LOWCOUNTRY BLVD
Second Line :
City : MOUNT PLEASANT
State : SC
Zip : 29464-3066
Country : US
Telephone Number : 843-501-1099
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2016
Last Update Date : 05/06/2026

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