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General NPI Number Information
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NPI Number | 1346695160
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Entity Type | Individual
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Provider Name | AMY FAVRO LMHC
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Gender | Female
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Dates
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Enumeration Date | 04/29/2016
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Last Update Date | 08/26/2019
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Provider Practice Location Address
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Address Line | 43 BROADWAY
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City | SARANAC LAKE
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State | NY
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Zip | 12983-1718
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Country | US
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Telephone | 518-354-1713
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Fax | 518-354-8414
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Provider Business Mailing Address
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Address Line | 43 BROADWAY
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City | SARANAC LAKE
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State | NY
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Zip | 12983-1718
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Country | US
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Telephone | 518-396-9141
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Fax | 518-354-8414
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 004481-1
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License Number State | NY
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