Provider Demographics
NPI:1770604985
Name:WARREN, AMY JANET (LMHC)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:JANET
Last Name:WARREN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1266 1ST ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-5519
Mailing Address - Country:US
Mailing Address - Phone:941-957-3366
Mailing Address - Fax:941-954-2335
Practice Address - Street 1:1266 1ST ST
Practice Address - Street 2:SUITE 2
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-5519
Practice Address - Country:US
Practice Address - Phone:941-957-3366
Practice Address - Fax:941-954-2335
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH003558101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health