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General NPI Number Information
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NPI Number | 1942602545
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Entity Type | Individual
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Provider Name | AMANDA FUTCH LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/25/2014
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 945 GRAND ST
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City | STARKE
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State | FL
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Zip | 32091-1821
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Country | US
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Telephone | 352-374-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 13521 PRESTWICK DR
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City | RIVERVIEW
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State | FL
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Zip | 33579-4038
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Country | US
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Telephone | 828-242-8930
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P008814
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW23479
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License Number State | FL
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