Provider Demographics
NPI:1598726994
Name:SCRIVENER, AMYE WALKER (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:AMYE
Middle Name:WALKER
Last Name:SCRIVENER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 HOSPITAL RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-4015
Mailing Address - Country:US
Mailing Address - Phone:410-535-2500
Mailing Address - Fax:410-535-6030
Practice Address - Street 1:130 HOSPITAL RD
Practice Address - Street 2:SUITE 101
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-4015
Practice Address - Country:US
Practice Address - Phone:410-535-2500
Practice Address - Fax:410-535-6030
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD088541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD411LD916Medicare ID - Type UnspecifiedMEDICARE ID
MDS70371Medicare UPIN