Provider Demographics
NPI:1356185623
Name:TEMPEL, AMY (LCSW)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:TEMPEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3805 E COUNTY ROAD 2000 N
Mailing Address - Street 2:
Mailing Address - City:DALE
Mailing Address - State:IN
Mailing Address - Zip Code:47523-9573
Mailing Address - Country:US
Mailing Address - Phone:812-455-6601
Mailing Address - Fax:
Practice Address - Street 1:3805 E COUNTY ROAD 2000 N
Practice Address - Street 2:
Practice Address - City:DALE
Practice Address - State:IN
Practice Address - Zip Code:47523-9573
Practice Address - Country:US
Practice Address - Phone:812-455-6601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34010890A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical