Provider Demographics
NPI:1306347844
Name:FEUSNER, AMY LOU (LCSW)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LOU
Last Name:FEUSNER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 CHESTER HAHN RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:40008-7077
Mailing Address - Country:US
Mailing Address - Phone:502-649-0979
Mailing Address - Fax:
Practice Address - Street 1:5793 LAWRENCEBURG RD
Practice Address - Street 2:
Practice Address - City:CHAPLIN
Practice Address - State:KY
Practice Address - Zip Code:40012-8000
Practice Address - Country:US
Practice Address - Phone:502-373-7832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-21
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY34421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical