Provider Demographics
NPI:1992361588
Name:BYRNE, AMY L (LPC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:BYRNE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7025 HARBOUR VIEW BLVD STE 119
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-2762
Mailing Address - Country:US
Mailing Address - Phone:757-404-0738
Mailing Address - Fax:
Practice Address - Street 1:7025 HARBOUR VIEW BLVD STE 119
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-2762
Practice Address - Country:US
Practice Address - Phone:757-404-0738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-20
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701008368101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional