Provider Demographics
NPI:1427547066
Name:NASH, AMY MICHELLE (LCSW)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:MICHELLE
Last Name:NASH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:MICHELLE
Other - Last Name:MESSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:249 DORAL DR
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-8054
Mailing Address - Country:US
Mailing Address - Phone:760-258-6925
Mailing Address - Fax:
Practice Address - Street 1:249 DORAL DR
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:NC
Practice Address - Zip Code:28443-8054
Practice Address - Country:US
Practice Address - Phone:760-258-6925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0114051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical