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General NPI Number Information
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NPI Number | 1851240154
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Entity Type | Individual
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Provider Name | AMY PETERSON
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Gender | Female
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Dates
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Enumeration Date | 01/28/2026
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 2250 THUNDERSTICK DR STE 1104
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City | LEXINGTON
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State | KY
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Zip | 40505-9009
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Country | US
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Telephone | 859-254-1035
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Fax |
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Provider Business Mailing Address
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Address Line | 1004 ASHBY CT
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City | LEXINGTON
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State | KY
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Zip | 40509-2360
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Country | US
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Telephone |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | CSW00001251
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License Number State | KY
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