Provider Demographics
NPI:1467791491
Name:PRENTICE, AMY NASEME (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:NASEME
Last Name:PRENTICE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 MANNING DR
Mailing Address - Street 2:CB 7586
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7586
Mailing Address - Country:US
Mailing Address - Phone:919-966-0249
Mailing Address - Fax:919-966-6126
Practice Address - Street 1:590 MANNING DR
Practice Address - Street 2:CB 7586
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7586
Practice Address - Country:US
Practice Address - Phone:919-966-0249
Practice Address - Fax:919-966-6126
Is Sole Proprietor?:No
Enumeration Date:2013-02-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical