Provider Demographics
NPI:1497176861
Name:MARQUARDT, AMY LEIGH (LPCC S)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LEIGH
Last Name:MARQUARDT
Suffix:
Gender:F
Credentials:LPCC S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 HILLSBORO AVE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40511-2107
Mailing Address - Country:US
Mailing Address - Phone:859-948-1270
Mailing Address - Fax:
Practice Address - Street 1:257 HILLSBORO AVE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40511-2107
Practice Address - Country:US
Practice Address - Phone:859-948-1270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-02
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYLPCPCC00223780101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional