Provider Demographics
NPI:1013588110
Name:HESNI, AMY ROSE (LMSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:ROSE
Last Name:HESNI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:ROSE
Other - Last Name:VINCENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:3090 E CORONADO TRL
Mailing Address - Street 2:
Mailing Address - City:RIMROCK
Mailing Address - State:AZ
Mailing Address - Zip Code:86335-5283
Mailing Address - Country:US
Mailing Address - Phone:928-567-1322
Mailing Address - Fax:928-567-1323
Practice Address - Street 1:3090 E CORONADO TRL
Practice Address - Street 2:
Practice Address - City:RIMROCK
Practice Address - State:AZ
Practice Address - Zip Code:86335-5283
Practice Address - Country:US
Practice Address - Phone:928-567-1322
Practice Address - Fax:928-567-1323
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10492104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker