Provider Demographics
NPI:1992965883
Name:DOLIVER, AMY SUE (LMSW)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:SUE
Last Name:DOLIVER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:SUE
Other - Last Name:DOLIVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4813 STATE HIGHWAY 23
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:13815-3188
Mailing Address - Country:US
Mailing Address - Phone:607-336-7918
Mailing Address - Fax:
Practice Address - Street 1:5 COURT ST
Practice Address - Street 2:SUITE 42, COUNTY OFFICE BUILDING
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815-1695
Practice Address - Country:US
Practice Address - Phone:607-337-1602
Practice Address - Fax:607-334-4519
Is Sole Proprietor?:No
Enumeration Date:2008-06-13
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0764351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical