Provider Demographics
NPI:1952823148
Name:MCINTYRE, AMY MICHELLE (LICSW)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:MICHELLE
Last Name:MCINTYRE
Suffix:
Gender:
Credentials:LICSW
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:MICHELLE
Other - Last Name:JENKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:726 SW PUFFIN ST
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-7224
Mailing Address - Country:US
Mailing Address - Phone:720-442-2007
Mailing Address - Fax:
Practice Address - Street 1:2511 M AVE STE G
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-3897
Practice Address - Country:US
Practice Address - Phone:360-299-4297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-10
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW366851041C0700X
CO009928361041C0700X
WA616757641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical