Provider Demographics
NPI:1023296233
Name:MORRIS, AMY ROSTAND (LCSW)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:ROSTAND
Last Name:MORRIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:AMY
Other - Middle Name:ROSTAND
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:115 EMERSON AVE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-2946
Mailing Address - Country:US
Mailing Address - Phone:404-373-7333
Mailing Address - Fax:
Practice Address - Street 1:1780 CENTURY BLVD NE STE B
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-3399
Practice Address - Country:US
Practice Address - Phone:404-647-3246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-11
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0030011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical