Provider Demographics
NPI:1568613578
Name:POPPEL, AMY BETH (LCSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:BETH
Last Name:POPPEL
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 1:1501 LOWER STATE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-1216
Mailing Address - Country:US
Mailing Address - Phone:215-716-3120
Mailing Address - Fax:
Practice Address - Street 1:1501 LOWER STATE RD
Practice Address - Street 2:
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-1216
Practice Address - Country:US
Practice Address - Phone:215-716-3120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-08
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0160541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical