Provider Demographics
NPI:1154551745
Name:EKINS, AMY GENIEL (LCSW-I)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:GENIEL
Last Name:EKINS
Suffix:
Gender:F
Credentials:LCSW-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7555 AVALON BAY ST.
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139
Mailing Address - Country:US
Mailing Address - Phone:702-385-1072
Mailing Address - Fax:702-385-3053
Practice Address - Street 1:4455 ALLEN LN STE 130
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-2229
Practice Address - Country:US
Practice Address - Phone:702-385-1072
Practice Address - Fax:702-385-3053
Is Sole Proprietor?:No
Enumeration Date:2009-07-17
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4532-S104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker