Provider Demographics
NPI:1386016111
Name:STRAIT, AMY (LPC, LPC/S, LAC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:STRAIT
Suffix:
Gender:F
Credentials:LPC, LPC/S, LAC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:HUDGINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:840 W RIVER GROVE CIR
Mailing Address - Street 2:
Mailing Address - City:ROEBUCK
Mailing Address - State:SC
Mailing Address - Zip Code:29376-3942
Mailing Address - Country:US
Mailing Address - Phone:864-399-7312
Mailing Address - Fax:864-536-0075
Practice Address - Street 1:269 S CHURCH ST STE 210
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29306-3483
Practice Address - Country:US
Practice Address - Phone:864-643-9188
Practice Address - Fax:864-536-0075
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-20
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6120101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor