Provider Demographics
NPI:1841345071
Name:HEIM, AMY LYNN (LCSW-R)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:LYNN
Last Name:HEIM
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:MRS
Other - First Name:AMY
Other - Middle Name:HEIM
Other - Last Name:SCOTTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:401 HUFCUT RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-3311
Mailing Address - Country:US
Mailing Address - Phone:845-598-4441
Mailing Address - Fax:
Practice Address - Street 1:401 HUFCUT RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-3311
Practice Address - Country:US
Practice Address - Phone:845-598-4441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0705591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN28A51Medicare ID - Type Unspecified