Provider Demographics
NPI:1811389661
Name:MAUS, AMY VANESSA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:VANESSA
Last Name:MAUS
Suffix:
Gender:F
Credentials:LCSW
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Other - First Name:
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Mailing Address - Street 1:12125 WOODCREST EXECUTIVE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-5001
Mailing Address - Country:US
Mailing Address - Phone:314-275-8599
Mailing Address - Fax:314-275-8299
Practice Address - Street 1:12125 WOODCREST EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-5001
Practice Address - Country:US
Practice Address - Phone:314-275-8599
Practice Address - Fax:314-275-8299
Is Sole Proprietor?:No
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO19991410481041C0700X
IL149.0087251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical