Provider Demographics
NPI:1154954659
Name:TRIPP, AMY (MS, LMSW)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:
Last Name:TRIPP
Suffix:
Gender:F
Credentials:MS, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 E 29TH ST APT 20H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-7435
Mailing Address - Country:US
Mailing Address - Phone:252-917-0137
Mailing Address - Fax:
Practice Address - Street 1:71 W 23RD ST STE 704
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-4299
Practice Address - Country:US
Practice Address - Phone:212-576-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-13
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY107163-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker