=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710324108
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMY G SCHWEIGERT PSYD, LP, LMFT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/27/2013
-----------------------------------------------------
Last Update Date | 01/04/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13750 CROSSTOWN DR NW STE 102
-----------------------------------------------------
City | ANDOVER
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55304-5855
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 763-310-8847
-----------------------------------------------------
Fax | 763-402-7541
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2665 4TH AVE STE 10
-----------------------------------------------------
City | ANOKA
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55303-1797
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 763-310-8847
-----------------------------------------------------
Fax | 763-402-7541
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 2270
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number | LP6025
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------