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General NPI Number Information
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NPI Number | 1659660462
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Entity Type | Individual
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Provider Name | ANNMARIE AMLICK LMHC
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Gender | Female
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Dates
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Enumeration Date | 04/01/2011
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Last Update Date | 04/01/2011
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Provider Practice Location Address
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Address Line | 13030 180TH ST
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City | JAMAICA
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State | NY
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Zip | 11434-4108
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Country | US
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Telephone | 718-527-2200
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Fax | 718-527-3707
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Provider Business Mailing Address
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Address Line | 6 CHARLES CT
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City | VALLEY STREAM
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State | NY
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Zip | 11580-5355
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Country | US
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Telephone | 516-850-1856
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Fax |
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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 | 003855
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License Number State | NY
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