Provider Demographics
NPI:1952445306
Name:STERN, AMY LYNNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:LYNNE
Last Name:STERN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3164 KENSINGTON RD
Mailing Address - Street 2:
Mailing Address - City:AVONDALE ESTATES
Mailing Address - State:GA
Mailing Address - Zip Code:30002-1456
Mailing Address - Country:US
Mailing Address - Phone:404-643-9939
Mailing Address - Fax:404-296-1667
Practice Address - Street 1:3164 KENSINGTON RD
Practice Address - Street 2:
Practice Address - City:AVONDALE ESTATES
Practice Address - State:GA
Practice Address - Zip Code:30002-1456
Practice Address - Country:US
Practice Address - Phone:404-643-9939
Practice Address - Fax:404-296-1667
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000024511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical