Provider Demographics
NPI:1568864544
Name:CADWELL, AMANDA (LPC, LCMHC, LPCC, LC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:CADWELL
Suffix:
Gender:F
Credentials:LPC, LCMHC, LPCC, LC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 HIGHWAY 160 W STE 101
Mailing Address - Street 2:PMB 251
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-8009
Mailing Address - Country:US
Mailing Address - Phone:803-859-4496
Mailing Address - Fax:803-266-6912
Practice Address - Street 1:7000 PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-2955
Practice Address - Country:US
Practice Address - Phone:803-859-4496
Practice Address - Fax:803-266-6912
Is Sole Proprietor?:No
Enumeration Date:2014-09-21
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19440101YP2500X
MN2109101YP2500X
IDLCPC-7297101YP2500X
SC8968101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1568864544Medicaid
SCPC3062Medicaid