Provider Demographics
NPI:1346014636
Name:HENRY, AMY ADAMS (MA, LPA, LSSP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:ADAMS
Last Name:HENRY
Suffix:
Gender:F
Credentials:MA, LPA, LSSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 S CENTRAL EXPY STE 200
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-4000
Mailing Address - Country:US
Mailing Address - Phone:214-550-7757
Mailing Address - Fax:
Practice Address - Street 1:2150 S CENTRAL EXPY STE 200
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-4000
Practice Address - Country:US
Practice Address - Phone:214-550-7757
Practice Address - Fax:214-550-7753
Is Sole Proprietor?:No
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6683103TS0200X
TX14196103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool