Healthcare Provider Details

I. General information

NPI: 1871959619
Provider Name (Legal Business Name): AMANDA LYNN ACREE LISW-CP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2016
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

871 LOWCOUNTRY BLVD
MOUNT PLEASANT SC
29464-3066
US

IV. Provider business mailing address

4800 N SCOTTSDALE RD STE 2500
SCOTTSDALE AZ
85251-7630
US

V. Phone/Fax

Practice location:
  • Phone: 843-501-1099
  • Fax:
Mailing address:
  • Phone: 843-501-1099
  • Fax: 843-405-2040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2013042279
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number18731
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: