Provider Demographics
NPI:1538294715
Name:SMITH, AMY LINNEA (LCSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LINNEA
Last Name:SMITH
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 1:1309 EVANS AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94124-1705
Mailing Address - Country:US
Mailing Address - Phone:415-206-7600
Mailing Address - Fax:415-206-7630
Practice Address - Street 1:1309 EVANS AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94124-1705
Practice Address - Country:US
Practice Address - Phone:415-206-7600
Practice Address - Fax:415-206-7630
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA692681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical