Provider Demographics
NPI:1699135426
Name:KROHN, AMY LUTRICIA (MA LPC CAGCS CDBT)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LUTRICIA
Last Name:KROHN
Suffix:
Gender:F
Credentials:MA LPC CAGCS CDBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 N BOLIVAR ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:TX
Mailing Address - Zip Code:75670-2017
Mailing Address - Country:US
Mailing Address - Phone:903-830-1101
Mailing Address - Fax:
Practice Address - Street 1:705 N BOLIVAR ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:TX
Practice Address - Zip Code:75670-2017
Practice Address - Country:US
Practice Address - Phone:903-830-1101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-07
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
LA6678101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health