Provider Demographics
NPI:1235481078
Name:HOGARTH, AMY ELIZABETH FEUCHT (MFT)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:ELIZABETH FEUCHT
Last Name:HOGARTH
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 LANCASTER ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-1905
Mailing Address - Country:US
Mailing Address - Phone:508-808-3910
Mailing Address - Fax:
Practice Address - Street 1:198 WATERMAN ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4033
Practice Address - Country:US
Practice Address - Phone:508-808-3910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-03
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CT106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist