Provider Demographics
NPI:1649598160
Name:LYKES, AMY (LMFT)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:
Last Name:LYKES
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 WINDPLAY DR STE 2
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-9319
Mailing Address - Country:US
Mailing Address - Phone:503-869-1236
Mailing Address - Fax:
Practice Address - Street 1:5000 WINDPLAY DR STE 2
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-9319
Practice Address - Country:US
Practice Address - Phone:503-317-9004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-07
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA125836106H00000X
WA00055252101YM0800X
CA83904101YM0800X, 320800000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness