Provider Demographics
NPI:1679819940
Name:HEALY-KRUMWIEDE, AMY (LMSW, LCSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:HEALY-KRUMWIEDE
Suffix:
Gender:F
Credentials:LMSW, LCSW
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LYNN
Other - Last Name:HEALY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW, LCSW
Mailing Address - Street 1:8623 N WAYNE RD STE 310
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-1137
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8623 N WAYNE RD STE 310
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-1137
Practice Address - Country:US
Practice Address - Phone:734-425-0636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-14
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801094703104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker