Provider Demographics
NPI:1104057371
Name:VALIMONT, AMY SUE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:SUE
Last Name:VALIMONT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:SUE
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4005 OLEANDER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6816
Mailing Address - Country:US
Mailing Address - Phone:910-790-9949
Mailing Address - Fax:910-790-9455
Practice Address - Street 1:4005 OLEANDER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6816
Practice Address - Country:US
Practice Address - Phone:910-790-9949
Practice Address - Fax:910-790-9455
Is Sole Proprietor?:No
Enumeration Date:2009-08-05
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0059461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6007455Medicaid