Provider Demographics
NPI:1982945390
Name:AMY SMALL, LLC
Entity Type:Organization
Organization Name:AMY SMALL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:SMALL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:305-607-4643
Mailing Address - Street 1:12550 BISCAYNE BLVD STE 408
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-2544
Mailing Address - Country:US
Mailing Address - Phone:305-607-4643
Mailing Address - Fax:305-866-3454
Practice Address - Street 1:12550 BISCAYNE BLVD
Practice Address - Street 2:SUITE 408
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2541
Practice Address - Country:US
Practice Address - Phone:305-607-4643
Practice Address - Fax:305-866-3454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-11
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW99281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty