Provider Demographics
NPI:1073531430
Name:KRANTZ METZGAR, AMY MARIE (MA, LPC, NCC, NCSC)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:MARIE
Last Name:KRANTZ METZGAR
Suffix:
Gender:F
Credentials:MA, LPC, NCC, NCSC
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:MARIE
Other - Last Name:FISHERAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 4734
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-4734
Mailing Address - Country:US
Mailing Address - Phone:704-881-3884
Mailing Address - Fax:704-896-7836
Practice Address - Street 1:8211 VILLAGE HARBOR DR
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-3706
Practice Address - Country:US
Practice Address - Phone:704-881-3884
Practice Address - Fax:704-896-7836
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4138101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional