=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710768312
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMY E. DYKE LMSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/10/2023
-----------------------------------------------------
Last Update Date | 02/13/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4312 CUTCANE RD
-----------------------------------------------------
City | MINERAL BLUFF
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30559
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-697-1120
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1366
-----------------------------------------------------
City | MURPHY
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28906-1366
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 505-270-1041
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | SWB-2023-0176
-----------------------------------------------------
License Number State | NM
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | SWB-2025-0442
-----------------------------------------------------
License Number State | NM
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | CSW009972
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------