MEDICARE: MRS. AMY LINDSAY EHRLICH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	104100000X	Social Worker	8619-S	NV

General Provider Information

NPI Number	:	1053565820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMY LINDSAY EHRLICH

Provider Business Mailing Address
First Line	:	3312 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1829
Country	:	US
Telephone Number	:	702-410-7825
Fax Number	:

Provider Business Practice Location Address
First Line	:	3312 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1829
Country	:	US
Telephone Number	:	702-410-7825
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2008
Last Update Date	:	03/31/2022

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