Provider Demographics
NPI:1346884681
Name:DAVIS, AMY S (LCSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:S
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:SCHOLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW-CC
Mailing Address - Street 1:181 FRANKLIN HEALTH CMNS
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04938-6144
Mailing Address - Country:US
Mailing Address - Phone:207-778-0482
Mailing Address - Fax:207-778-0133
Practice Address - Street 1:181 FRANKLIN HEALTH CMNS
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04938-6144
Practice Address - Country:US
Practice Address - Phone:207-778-0482
Practice Address - Fax:207-778-0133
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-30
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC216121041C0700X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No251S00000XAgenciesCommunity/Behavioral Health