Provider Demographics
NPI:1609316967
Name:JUSTICE, AMY LYNNE (NCC, LCMHC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LYNNE
Last Name:JUSTICE
Suffix:
Gender:F
Credentials:NCC, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 FOX FIRE ESTATES CIR
Mailing Address - Street 2:
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28785-8999
Mailing Address - Country:US
Mailing Address - Phone:910-779-9267
Mailing Address - Fax:
Practice Address - Street 1:204 CHARLOTTE HWY STE E
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-8681
Practice Address - Country:US
Practice Address - Phone:828-333-5708
Practice Address - Fax:828-484-1025
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-06
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA12636101YM0800X
NC12636101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health