Individual provider Active NPI

Amanda Woodman Swartzlender

  • Mental Health Counselor
  • St Augustine, FL
National Provider Identifier
1982978565
Registry record updated Jan 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH12109 Issued in FL
Practice address
631 Market St
St Augustine, FL 32095-8892
Phone
(808) 258-8089
Fax
(904) 687-0551
NPI assigned
Feb 29, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMH9369 FL
Mental Health Counselor 101YM0800X MH12109 FL Primary

Addresses

Primary practice location

631 Market St
St Augustine, FL 32095-8892

Mailing address

631 McKenzie Oak LN
St Augustine, FL 32095-6861
Phone (808) 258-8089

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 22, 2025 through Jan 22, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
IMH9369FLMDMental Health Counselor
MH12109FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Intuition Wellness, LLC Mental Health CurrentSince Mar 16, 2021 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1330473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388966400000",
    "number": "1982978565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 MCKENZIE OAK LN",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320956861",
            "telephone_number": "808-258-8089",
            "fax_number": "904-940-6982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 MARKET ST",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320958892",
            "telephone_number": "808-258-8089",
            "fax_number": "904-687-0551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWARTZLENDER",
        "first_name": "AMANDA",
        "middle_name": "WOODMAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-29",
        "last_updated": "2014-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH9369",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH12109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.