Provider Demographics
NPI:1982011565
Name:DEUTSCH, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:DEUTSCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:DEUTSCH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:102 E 22ND ST
Mailing Address - Street 2:#5H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-5404
Mailing Address - Country:US
Mailing Address - Phone:646-344-9925
Mailing Address - Fax:
Practice Address - Street 1:102 E 22ND ST
Practice Address - Street 2:#5H
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5404
Practice Address - Country:US
Practice Address - Phone:646-344-9925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071213-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical