Provider Demographics
NPI:1003051590
Name:HEINZ, AMY DAWN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:DAWN
Last Name:HEINZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:DAWN
Other - Last Name:FOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:WOUNDED WARRIOR BATTALION BLDG PP3
Mailing Address - Street 2:VA LIAISION FOR HEALTHCARE RM 143
Mailing Address - City:CAMP LEJEUNE
Mailing Address - State:NC
Mailing Address - Zip Code:28542
Mailing Address - Country:US
Mailing Address - Phone:910-528-6603
Mailing Address - Fax:910-450-7177
Practice Address - Street 1:WOUNDED WARRIOR BATTALION BLDG PP3
Practice Address - Street 2:VA LIAISON FOR HEALTHCARE RM 143
Practice Address - City:CAMP LEJEUNE
Practice Address - State:NC
Practice Address - Zip Code:28542
Practice Address - Country:US
Practice Address - Phone:910-528-6603
Practice Address - Fax:910-450-7177
Is Sole Proprietor?:No
Enumeration Date:2008-12-11
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0053171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical