Provider Demographics
NPI:1003984501
Name:HAUGE, AMY L (LPC-MH, QMHP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:HAUGE
Suffix:
Gender:F
Credentials:LPC-MH, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 RAILROAD AVE SE STE 1
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-4208
Mailing Address - Country:US
Mailing Address - Phone:605-725-5505
Mailing Address - Fax:
Practice Address - Street 1:125 RAILROAD AVE SE STE 1
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-4208
Practice Address - Country:US
Practice Address - Phone:605-725-5505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC-MH2231101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health