Provider Demographics
NPI:1497995559
Name:CRUMLY, AMY LEIGH (PHD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:LEIGH
Last Name:CRUMLY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 PINEHURST AVE APT F4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-1755
Mailing Address - Country:US
Mailing Address - Phone:212-491-2317
Mailing Address - Fax:212-491-2323
Practice Address - Street 1:116 PINEHURST AVE APT F4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-1755
Practice Address - Country:US
Practice Address - Phone:212-491-2317
Practice Address - Fax:212-491-2323
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0577321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical