Healthcare Provider Details

I. General information

NPI: 1760037170
Provider Name (Legal Business Name): AMANDA LOOMAN SWT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMANDA LOOMAN LCDC III

II. Dates (important events)

Enumeration Date: 08/04/2019
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 N MICHIGAN ST STE 914
TOLEDO OH
43604-5665
US

IV. Provider business mailing address

316 N MICHIGAN ST STE 914
TOLEDO OH
43604-5665
US

V. Phone/Fax

Practice location:
  • Phone: 419-246-9405
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2504316-TRNE
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: