Provider Demographics
NPI:1952703001
Name:WU, AMY YI-SHIUAN (LMFT)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:YI-SHIUAN
Last Name:WU
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8957 LAVERGNE AVE
Mailing Address - Street 2:APARTMENT 1A
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-1658
Mailing Address - Country:US
Mailing Address - Phone:646-464-2556
Mailing Address - Fax:773-365-3093
Practice Address - Street 1:10024 SKOKIE BLVD
Practice Address - Street 2:SUITE 311
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-9944
Practice Address - Country:US
Practice Address - Phone:646-464-2556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-19
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166.000964106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist