Provider Demographics
NPI:1427232198
Name:TRADER, AMY (LPC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:TRADER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1477 EBENEZER RD
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-2338
Mailing Address - Country:US
Mailing Address - Phone:803-517-2323
Mailing Address - Fax:800-787-7882
Practice Address - Street 1:1477 EBENEZER RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-2338
Practice Address - Country:US
Practice Address - Phone:803-517-2323
Practice Address - Fax:800-787-7882
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-18
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health