Provider Demographics
NPI:1922026947
Name:HALE, AMY J (LMSW)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:J
Last Name:HALE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:J
Other - Last Name:STAMPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:2820 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:ESCANABA
Mailing Address - State:MI
Mailing Address - Zip Code:49829-9591
Mailing Address - Country:US
Mailing Address - Phone:906-226-0029
Mailing Address - Fax:906-233-1235
Practice Address - Street 1:200 W SPRING ST
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-4630
Practice Address - Country:US
Practice Address - Phone:906-226-0029
Practice Address - Fax:906-233-1235
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010708821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIN21670035Medicare ID - Type Unspecified