Provider Demographics
NPI:1497209449
Name:RAGSDALE, AMY WERNER (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:WERNER
Last Name:RAGSDALE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:ANDERSON
Other - Last Name:WERNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:14 BUTLER ST
Mailing Address - Street 2:APT 1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-4707
Mailing Address - Country:US
Mailing Address - Phone:202-841-2887
Mailing Address - Fax:
Practice Address - Street 1:1841 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7603
Practice Address - Country:US
Practice Address - Phone:212-333-3444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-08
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY088956104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker