Provider Demographics
NPI:1891131371
Name:WINEBARGER, AMY (LMSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:WINEBARGER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37450 SCHOOLCRAFT RD STE 170
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-1081
Mailing Address - Country:US
Mailing Address - Phone:734-744-0170
Mailing Address - Fax:734-744-0171
Practice Address - Street 1:37450 SCHOOLCRAFT RD STE 170
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1081
Practice Address - Country:US
Practice Address - Phone:734-744-0170
Practice Address - Fax:734-744-0171
Is Sole Proprietor?:No
Enumeration Date:2013-05-10
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010900391041C0700X
MIC-01686101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)