Provider Demographics
NPI:1144378894
Name:ROUSE, AMY CARTER (LCSW)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:CARTER
Last Name:ROUSE
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 1:520 E MAXWELL ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-6432
Mailing Address - Country:US
Mailing Address - Phone:859-233-3390
Mailing Address - Fax:859-243-9906
Practice Address - Street 1:520 E MAXWELL ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-6432
Practice Address - Country:US
Practice Address - Phone:859-233-3390
Practice Address - Fax:859-243-9906
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY19101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical