Healthcare Provider Details

I. General information

NPI: 1265893259
Provider Name (Legal Business Name): AMY M. ENKLING MA, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2016
Last Update Date: 10/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5580 PARK BLVD N STE 6 SUITE M
PINELLAS PARK FL
33781-3328
US

IV. Provider business mailing address

5580 PARK BLVD N STE 6 SUITE M
PINELLAS PARK FL
33781-3328
US

V. Phone/Fax

Practice location:
  • Phone: 407-694-1966
  • Fax:
Mailing address:
  • Phone: 407-694-1966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH 13430
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: