Provider Demographics
NPI:1154928174
Name:SOMERS, AMY SAUM (LPCC #4549)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:SAUM
Last Name:SOMERS
Suffix:
Gender:F
Credentials:LPCC #4549
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 2426
Mailing Address - Street 2:# 100
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93921
Mailing Address - Country:US
Mailing Address - Phone:831-296-2035
Mailing Address - Fax:
Practice Address - Street 1:LINCOLN 2 NW OF 7TH ST.
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93921-9392
Practice Address - Country:US
Practice Address - Phone:831-296-2035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4549101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health