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General NPI Number Information
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NPI Number | 1952087652
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Entity Type | Individual
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Provider Name | AMANDA LYNN RICHARD LMSW
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Gender | Female
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Dates
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Enumeration Date | 06/26/2023
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 2483 S LINDEN RD STE 20
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City | FLINT
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State | MI
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Zip | 48532-5454
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Country | US
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Telephone | 248-369-7235
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Fax | 855-437-1506
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Provider Business Mailing Address
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Address Line | 12366 SAINT ANDREWS WAY
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City | FENTON
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State | MI
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Zip | 48430-8879
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Country | US
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Telephone | 248-369-7235
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Fax | 855-437-1506
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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 | 6801113612
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License Number State | MI
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