Healthcare Provider Details

I. General information

NPI: 1205745379
Provider Name (Legal Business Name): AMANDA MOFFITT, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 GREAT HILL DR
WEYMOUTH MA
02191-1905
US

IV. Provider business mailing address

PO BOX 32
WEYMOUTH MA
02191-0001
US

V. Phone/Fax

Practice location:
  • Phone: 781-277-7073
  • Fax:
Mailing address:
  • Phone: 781-277-7073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: AMANDA MOFFITT
Title or Position: OWNER/PRESIDENT/CEO
Credential: LMHC
Phone: 781-277-7073