Provider Demographics
NPI:1962902668
Name:SPERBER, AMY (LPCC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:SPERBER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:MEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 HOME RD
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41011-1942
Mailing Address - Country:US
Mailing Address - Phone:859-261-8768
Mailing Address - Fax:859-291-2431
Practice Address - Street 1:200 HOME RD
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:KY
Practice Address - Zip Code:41011-1942
Practice Address - Country:US
Practice Address - Phone:859-261-8768
Practice Address - Fax:859-291-2431
Is Sole Proprietor?:No
Enumeration Date:2018-02-19
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY174383221700000X
KY175072101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100515870Medicaid