Provider Demographics
NPI:1285125674
Name:HENRY, AMY (LCPC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:HENRY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11325 BRANDY HALL LN
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-2533
Mailing Address - Country:US
Mailing Address - Phone:301-412-5148
Mailing Address - Fax:
Practice Address - Street 1:3615 E JOPPA RD STE 270
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-3347
Practice Address - Country:US
Practice Address - Phone:410-215-6906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC11700101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101Y00000XBehavioral Health & Social Service ProvidersCounselor