Provider Demographics
NPI:1699083071
Name:KIRCHNER, AMY MARIE (LMHC)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:MARIE
Last Name:KIRCHNER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 ORANGE ST
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32084-3633
Mailing Address - Country:US
Mailing Address - Phone:904-547-7481
Mailing Address - Fax:
Practice Address - Street 1:40 ORANGE ST
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084-3633
Practice Address - Country:US
Practice Address - Phone:904-547-7481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-20
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH13664101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health