Provider Demographics
NPI:1740691559
Name:LAY, AMANDA ELISE (MSW)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:ELISE
Last Name:LAY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 POPE AVE
Mailing Address - Street 2:
Mailing Address - City:HARRODSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40330-7504
Mailing Address - Country:US
Mailing Address - Phone:859-612-8150
Mailing Address - Fax:
Practice Address - Street 1:106 BELINDA BLVD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-3217
Practice Address - Country:US
Practice Address - Phone:859-209-2320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-14
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker