Provider Demographics
NPI:1770767287
Name:STEIN, AMY E (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:E
Last Name:STEIN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 FRIENDS LN
Mailing Address - Street 2:SUITE 114
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-3403
Mailing Address - Country:US
Mailing Address - Phone:215-860-9742
Mailing Address - Fax:215-860-9758
Practice Address - Street 1:54 FRIENDS LN
Practice Address - Street 2:SUITE 114
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-3403
Practice Address - Country:US
Practice Address - Phone:215-860-9742
Practice Address - Fax:215-860-9758
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-19
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA214720104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1300709Medicaid