Provider Demographics
NPI:1114476793
Name:HALTER, AMY KARA (MSW)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:KARA
Last Name:HALTER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 GASKILL ST SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316-1116
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 FEDERAL ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110-1817
Practice Address - Country:US
Practice Address - Phone:206-744-8030
Practice Address - Fax:206-744-8652
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-24
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0889011041C0700X
GACSW0090571041C0700X
WALW608590651041C0700X
MALICSW1273641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical