Provider Demographics
NPI:1093749327
Name:TOWNE, AMIE NICOLE (LMSW)
Entity Type:Individual
Prefix:
First Name:AMIE
Middle Name:NICOLE
Last Name:TOWNE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:AMIE
Other - Middle Name:NICOLE
Other - Last Name:BUTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:N2171 CTY RD K
Mailing Address - Street 2:
Mailing Address - City:WAUPACA
Mailing Address - State:WI
Mailing Address - Zip Code:54981-8351
Mailing Address - Country:US
Mailing Address - Phone:707-330-4828
Mailing Address - Fax:
Practice Address - Street 1:330 W COLLEGE AVE STE 303
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-5871
Practice Address - Country:US
Practice Address - Phone:617-379-0496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8870-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIAT084174OtherBCBS OF MI
MI345735OtherMHN
MIAT084174OtherBCBS OF MI