Provider Demographics
NPI:1992120430
Name:SWEET, AMANDA L (PSYD)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:L
Last Name:SWEET
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22670 SUMMIT DR STE 2
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-7208
Mailing Address - Country:US
Mailing Address - Phone:315-775-3790
Mailing Address - Fax:
Practice Address - Street 1:22670 SUMMIT DR STE B
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-7209
Practice Address - Country:US
Practice Address - Phone:315-788-3332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-20
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY10061103T00000X
NY021062103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist