MEDICARE: AMY HEINRICH LMSW

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	1041C0700X	Clinical Social Worker	6801086917	MI

General Provider Information

NPI Number	:	1194102681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY HEINRICH LMSW

Provider Business Mailing Address
First Line	:	PO BOX 796
Second Line	:
City	:	OKEMOS
State	:	MI
Zip	:	48805-0796
Country	:	US
Telephone Number	:	517-420-3550
Fax Number	:	517-292-0919

Provider Business Practice Location Address
First Line	:	4011 WOODCREEK LN
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48911-1930
Country	:	US
Telephone Number	:	517-272-0918
Fax Number	:

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

Provider Enumeration Date	:	05/04/2015
Last Update Date	:	05/04/2015

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