Provider Demographics
NPI:1386973063
Name:RICH, AMY L (LCPC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:RICH
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 1:8651 COBSCOOK HARBOUR
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-2542
Mailing Address - Country:US
Mailing Address - Phone:443-800-5358
Mailing Address - Fax:
Practice Address - Street 1:9199 REISTERSTOWN ROAD
Practice Address - Street 2:SUITE 104B & 105B
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117
Practice Address - Country:US
Practice Address - Phone:410-552-0773
Practice Address - Fax:443-200-0267
Is Sole Proprietor?:No
Enumeration Date:2009-12-09
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2861101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional