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General NPI Number Information
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NPI Number | 1275193096
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Entity Type | Individual
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Provider Name | AMANDA PAULSON LMSW, MHP, CMHP
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Gender | Female
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Dates
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Enumeration Date | 06/14/2019
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 173 DEVONSHIRE DR
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City | DIMONDALE
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State | MI
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Zip | 48821-8767
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Country | US
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Telephone | 810-938-9931
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Fax |
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Provider Business Mailing Address
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Address Line | 123 N BRIDGE ST
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City | LINDEN
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State | MI
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Zip | 48451-8824
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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