Amanda Swanson, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

99076876A Issued in IN

Practice address

1015 Michigan Ave
Logansport, IN 46947-1526

Phone

(574) 722-5151

Fax

(574) 739-1414

NPI assigned

Oct 30, 2014

Last updated

Dec 7, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Amanda Borrelli Former name

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Psychological and Life Skills Associates, P.C.

  • Psychologist
  • Woodbridge, VA
  • NPI 1619066727
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1414627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481068800000",
    "number": "1801291026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 MICHIGAN AVE",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469471526",
            "telephone_number": "574-722-5151",
            "fax_number": "574-739-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 MICHIGAN AVE",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469471526",
            "telephone_number": "574-722-5151",
            "fax_number": "574-739-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-30",
        "last_updated": "2016-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "99076876A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "BORRELLI",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kathy Strong, BS
• Pia Victoria Strong, FNP-C
• Stacie L Stutzman, FNP
• Jennifer Leann Sullivan, BS
• Levi Eugene Sutton
• Shanan Swartz
• Matthew Jason Tanner
• Suzanne M Tanner, BS
• Lois Jane Taylor, CANP
• Sara Tedrick, BA

• Psychologist in Logansport, IN
• Providers in Logansport, IN by specialty
• Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.