Healthcare Provider Details

I. General information

NPI: 1578699930
Provider Name (Legal Business Name): AMY KAY GUTHRIE MA, LP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 03/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 7TH ST
PARKERSBURG WV
26101-3803
US

IV. Provider business mailing address

1409 24TH ST
VIENNA WV
26105-2367
US

V. Phone/Fax

Practice location:
  • Phone: 304-485-1721
  • Fax: 304-485-6710
Mailing address:
  • Phone: 304-422-1464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number894
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number894
License Number StateWV
# 3
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number894
License Number StateWV
# 4
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number894
License Number StateWV
# 5
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number894
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: