Healthcare Provider Details

I. General information

NPI: 1083479208
Provider Name (Legal Business Name): AMYE NICOLE LLAMAS LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2024
Last Update Date: 02/21/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

741 5TH ST SW
HICKORY NC
28602-3230
US

IV. Provider business mailing address

741 5TH ST SW
HICKORY NC
28602-3230
US

V. Phone/Fax

Practice location:
  • Phone: 828-322-5915
  • Fax: 828-345-0387
Mailing address:
  • Phone: 828-322-5915
  • Fax: 828-345-0387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberP020159
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: