Provider Demographics
NPI:1114476793
Name:HALTER, AMY KARA (MSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:KARA
Last Name:HALTER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 COOK ST
Mailing Address - Street 2:APT B4
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-4037
Mailing Address - Country:US
Mailing Address - Phone:206-744-8030
Mailing Address - Fax:206-744-8652
Practice Address - Street 1:325 9TH AVE
Practice Address - Street 2:BOX 359760
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104
Practice Address - Country:US
Practice Address - Phone:206-744-8030
Practice Address - Fax:206-744-8652
Is Sole Proprietor?:No
Enumeration Date:2016-09-24
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0889011041C0700X
WALW608590651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical