Provider Demographics
NPI:1093261265
Name:HEALY, AMIE NICOLE
Entity type:Individual
Prefix:MRS
First Name:AMIE
Middle Name:NICOLE
Last Name:HEALY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:AMIE
Other - Middle Name:NICOLE
Other - Last Name:ORTIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:124 E PRICE RD
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-5137
Mailing Address - Country:US
Mailing Address - Phone:407-312-2158
Mailing Address - Fax:
Practice Address - Street 1:124 E PRICE RD
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-5137
Practice Address - Country:US
Practice Address - Phone:407-312-2158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-28
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
FLMH17193101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health