Provider Demographics
NPI:1184680738
Name:POOLE, AMY MURPHREE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:MURPHREE
Last Name:POOLE
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 1:3411 SILVERSIDE RD
Mailing Address - Street 2:STE 102
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4812
Mailing Address - Country:US
Mailing Address - Phone:302-778-1288
Mailing Address - Fax:302-778-1289
Practice Address - Street 1:3411 SILVERSIDE RD
Practice Address - Street 2:STE 102
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4812
Practice Address - Country:US
Practice Address - Phone:302-778-1288
Practice Address - Fax:302-778-1289
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00006691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE232905LCSOtherBLUE CROSS
DE1000028590Medicaid