MEDICARE: MRS. AMANDA A SPIVEY MA, LPCA, NCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	10438	SC

General Provider Information

NPI Number	:	1093608556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMANDA A SPIVEY MA, LPCA, NCC

Provider Business Mailing Address
First Line	:	687 CASTLE PINCKNEY DR
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29412-4404
Country	:	US
Telephone Number	:	843-340-2224
Fax Number	:

Provider Business Practice Location Address
First Line	:	825 LOWCOUNTRY BLVD STE 205
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29464-3065
Country	:	US
Telephone Number	:	843-994-2838
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2025
Last Update Date	:	06/02/2025

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