Provider Demographics
NPI:1114261286
Name:ECHSTENKAMPER, AMY MICHELLE (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:MICHELLE
Last Name:ECHSTENKAMPER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 W 24TH ST APT 205
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23517-1235
Mailing Address - Country:US
Mailing Address - Phone:919-423-3153
Mailing Address - Fax:
Practice Address - Street 1:1301 FIRST COLONIAL RD STE 200
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-2263
Practice Address - Country:US
Practice Address - Phone:757-568-5582
Practice Address - Fax:757-578-8237
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0076691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical