Provider Demographics
NPI:1851924823
Name:HENDRICKS, AMY (LSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:HENDRICKS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:HENDRICKS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:492 ROUTE 57 WEST
Mailing Address - Street 2:FAMILY GUIDANCE CENTER OF WARREN COUNTY
Mailing Address - City:WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07882-4411
Mailing Address - Country:US
Mailing Address - Phone:908-689-1000
Mailing Address - Fax:908-689-4529
Practice Address - Street 1:492 ROUTE 57 WEST
Practice Address - Street 2:FAMILY GUIDANCE CENTER OF WARREN COUNTY
Practice Address - City:WASHINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07882-4411
Practice Address - Country:US
Practice Address - Phone:908-689-1000
Practice Address - Fax:908-689-4529
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06499100104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker