Provider Demographics
NPI:1558370494
Name:BRITTON-MCQUADE, AMY CHRISTINE (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:CHRISTINE
Last Name:BRITTON-MCQUADE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:CHRISTINE
Other - Last Name:BRITTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:PO BOX 9305
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-0305
Mailing Address - Country:US
Mailing Address - Phone:304-767-7820
Mailing Address - Fax:304-767-7829
Practice Address - Street 1:4607 MACCORKLE AVE SW
Practice Address - Street 2:SUITE 305
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1364
Practice Address - Country:US
Practice Address - Phone:304-767-7820
Practice Address - Fax:304-767-7829
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVDP00940852104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker