Provider Demographics
NPI:1013696665
Name:SANTOS, AMIE E (MSW)
Entity Type:Individual
Prefix:
First Name:AMIE
Middle Name:E
Last Name:SANTOS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 GROVE ST
Mailing Address - Street 2:3 FL
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-3934
Mailing Address - Country:US
Mailing Address - Phone:508-755-0333
Mailing Address - Fax:
Practice Address - Street 1:288 GROVE ST
Practice Address - Street 2:3 FL
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-3934
Practice Address - Country:US
Practice Address - Phone:508-755-0333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0427015811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical