AMANDA WOODMAN SWARTZLENDER , NPI 1982978565 — ST AUGUSTINE (FL)

NPI 1982978565

7+ Years Experience Individual

AMANDA WOODMAN SWARTZLENDER

02/29/2012
PROVIDER ENUMERATION DATE
01.06.2014
LAST UPDATE DATE
1982978565
NPI NUMBER

About AMANDA WOODMAN SWARTZLENDER

Sole proprietor? Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor.

AMANDA WOODMAN SWARTZLENDER is a provider established in ST AUGUSTINE, FL. The NPI number of AMANDA WOODMAN SWARTZLENDER is 1982978565 and was assigned on 02/29/2012. The practitioners primary taxonomy code is: 101YM0800X with license number: IMH9369 FL .

Mailing address

  • City: ST AUGUSTINE
  • State: FL
  • Postal code: 320956861
  • Phone: 8082588089
  • Fax: 9049406982
  • Address: 631 MCKENZIE OAK LN

Primary Practice Address

  • Region : ST AUGUSTINE, FL
  • NPI : 1982978565
  • Phone : 8082588089
  • Fax : 9046870551
  • Postalcode : 320958892
  • Address : 631 MARKET ST

Provider taxonomy - Counselor

  • Taxonomy code: 101YM0800X
  • License number: IMH9369
  • License state: FL

The taxonomy is not the primary taxonomy.

Healthcare provider taxonomy #2 - Counselor

  • Taxonomy code: 101YM0800X
  • License number: MH12109
  • License state: FL

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Contacts:

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  • AMANDA WOODMAN SWARTZLENDER
  • Address : 631 MARKET ST
  • Region : ST AUGUSTINE, FL
  • NPI : 1982978565
  • Phone : 8082588089
  • Fax : 9046870551
  • Postalcode : 320958892

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address631 MARKET ST
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameST AUGUSTINE
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameFL
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code320958892
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number8082588089
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number9046870551
The fax number associated with the location address of the provider being identified.
NPI1982978565
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1101YM0800X
Provider Enumeration Date02/29/2012
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated01.06.2014
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)AMANDA WOODMAN SWARTZLENDER
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address631 MCKENZIE OAK LN
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameST AUGUSTINE
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameFL
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code320956861
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number8082588089
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number9049406982
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Healthcare Provider Taxonomy Code #1101YM0800X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Counselor
Provider License Number 1IMH9369
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1FL
Healthcare Provider Primary Taxonomy Switch 1N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 2101YM0800X
Healthcare Provider Taxonomy 2Counselor
Provider License Number 2MH12109
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 2FL
Healthcare Provider Primary Taxonomy Switch 2Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeF
  • M - male
  • F - female
Is sole proprietorY
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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