Provider Demographics
NPI:1619480746
Name:KUYKENDALL, AMIE ELIZABETH (LCSW-S)
Entity Type:Individual
Prefix:
First Name:AMIE
Middle Name:ELIZABETH
Last Name:KUYKENDALL
Suffix:
Gender:F
Credentials:LCSW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 MEDICAL DR STE 117
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-5623
Mailing Address - Country:US
Mailing Address - Phone:210-777-2138
Mailing Address - Fax:210-569-7770
Practice Address - Street 1:4201 MEDICAL DR STE 117
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5623
Practice Address - Country:US
Practice Address - Phone:210-777-2138
Practice Address - Fax:210-569-7770
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-11
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX547671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical