Provider Demographics
NPI:1083595011
Name:MICHAEL AMORY LCSW THERAPY PLLC
Entity type:Organization
Organization Name:MICHAEL AMORY LCSW THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AMORY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:978-464-1308
Mailing Address - Street 1:360 NEW DORP LN
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-3035
Mailing Address - Country:US
Mailing Address - Phone:978-464-1308
Mailing Address - Fax:
Practice Address - Street 1:216 RICHARDSON ST APT 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-0480
Practice Address - Country:US
Practice Address - Phone:978-464-1308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty