Provider Demographics
NPI:1063663201
Name:SWIER-VOSNOS, AMY (PSYD HSPP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:SWIER-VOSNOS
Suffix:
Gender:
Credentials:PSYD HSPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6296 RUCKER RD STE A
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-4852
Mailing Address - Country:US
Mailing Address - Phone:317-550-3043
Mailing Address - Fax:
Practice Address - Street 1:6296 RUCKER RD
Practice Address - Street 2:SUITE A
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-4888
Practice Address - Country:US
Practice Address - Phone:317-550-3043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-07
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071008057103TC0700X
IN20042634A103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201129640Medicaid
INP01180281OtherRR MEDICARE PTAN
IN259690002Medicare PIN