Provider Demographics
NPI:1740671437
Name:MASSIE, AMY LEE (LPC)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:LEE
Last Name:MASSIE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:201 TOWN CENTER LN APT 1417
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-2162
Mailing Address - Country:US
Mailing Address - Phone:817-891-3410
Mailing Address - Fax:772-675-9100
Practice Address - Street 1:2141 KIRKWOOD BLVD STE 130
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-1464
Practice Address - Country:US
Practice Address - Phone:817-477-6323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-17
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82517101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional