MEDICARE: AMY STURT ROYAL LCSWA

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	10332	TN
2	1041C0700X	Clinical Social Worker	C019413	NC

General Provider Information

NPI Number	:	1295412120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY STURT ROYAL LCSWA

Provider Business Mailing Address
First Line	:	1308 HOWARD AVE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37216-2719
Country	:	US
Telephone Number	:	704-661-8016
Fax Number	:

Provider Business Practice Location Address
First Line	:	1308 HOWARD AVE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37216-2719
Country	:	US
Telephone Number	:	704-661-8016
Fax Number	:

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

Provider Enumeration Date	:	07/03/2023
Last Update Date	:	05/19/2026

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