Provider Demographics
NPI:1073762811
Name:AMIOT, BECKY SUE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BECKY
Middle Name:SUE
Last Name:AMIOT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 MOUNT VERNON LN
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-2700
Mailing Address - Country:US
Mailing Address - Phone:540-389-5468
Mailing Address - Fax:540-387-5082
Practice Address - Street 1:860 MOUNT VERNON LN
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-2700
Practice Address - Country:US
Practice Address - Phone:540-389-5468
Practice Address - Fax:540-387-5082
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040060211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical