Provider Demographics
NPI:1114329414
Name:PLANK, AMY LYNN (CSW)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LYNN
Last Name:PLANK
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LYNN
Other - Last Name:CARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:900 BEASLEY ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-4266
Mailing Address - Country:US
Mailing Address - Phone:859-254-1035
Mailing Address - Fax:859-254-2075
Practice Address - Street 1:900 BEASLEY ST
Practice Address - Street 2:SUITE 120
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-4266
Practice Address - Country:US
Practice Address - Phone:859-254-1035
Practice Address - Fax:859-254-2075
Is Sole Proprietor?:No
Enumeration Date:2014-09-18
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3631104100000X
KY252199104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker