Provider Demographics
NPI:1134626971
Name:LABOUNTY, AMY MARIE RAUCH (LCSWA)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:MARIE RAUCH
Last Name:LABOUNTY
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:MRS
Other - First Name:AMY
Other - Middle Name:MARIE
Other - Last Name:RAUCH-LABOUNTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:655 7TH ST
Mailing Address - Street 2:
Mailing Address - City:ROBINS AFB
Mailing Address - State:GA
Mailing Address - Zip Code:31098-2227
Mailing Address - Country:US
Mailing Address - Phone:783-278-4044
Mailing Address - Fax:
Practice Address - Street 1:655 7TH ST
Practice Address - Street 2:
Practice Address - City:ROBINS AFB
Practice Address - State:GA
Practice Address - Zip Code:31098-2227
Practice Address - Country:US
Practice Address - Phone:478-397-4304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
NCC012780104100000X
NDP0121101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical