Provider Demographics
NPI:1114491180
Name:KOHN MCNELLY, AMY (LCMFT, LMFT, CAC-II)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:KOHN MCNELLY
Suffix:
Gender:F
Credentials:LCMFT, LMFT, CAC-II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12103 STONEY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-1165
Mailing Address - Country:US
Mailing Address - Phone:301-803-0197
Mailing Address - Fax:
Practice Address - Street 1:8607 CEDAR ST
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4324
Practice Address - Country:US
Practice Address - Phone:240-200-5401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLMFT000144106H00000X
VALMFT717001490106H00000X
MDLCM707106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist