Provider Demographics
NPI:1184709784
Name:HUBBARD, AMY KATHERINE (MS, LMHC)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:KATHERINE
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01930-5120
Mailing Address - Country:US
Mailing Address - Phone:978-879-7188
Mailing Address - Fax:978-231-0528
Practice Address - Street 1:630 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:MA
Practice Address - Zip Code:01930-5120
Practice Address - Country:US
Practice Address - Phone:978-879-7188
Practice Address - Fax:978-231-0528
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7895101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health