Provider Demographics
NPI:1962813386
Name:AMY L. JUNEAU, LMSW, OSW-C, LLC
Entity Type:Organization
Organization Name:AMY L. JUNEAU, LMSW, OSW-C, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL ONCOLOGY SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:JUNEAU
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, OSW-C
Authorized Official - Phone:231-622-5216
Mailing Address - Street 1:600 CHARLEVOIX AVE
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2287
Mailing Address - Country:US
Mailing Address - Phone:231-622-5216
Mailing Address - Fax:888-974-3351
Practice Address - Street 1:600 CHARLEVOIX AVE
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2287
Practice Address - Country:US
Practice Address - Phone:231-622-5216
Practice Address - Fax:888-974-3351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-20
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010916751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty