Look up the most recent NPI and PECOS records

Amy Clark

Counselor

Behavioral Health & Social Service Providers

7459 Burlington Pike, Florence, KY 41042-1553

(859) 331-3292 (859) 578-3204

PECOS Enrollment

Based on the most recent information from CMS, provider Amy Clark does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1609262195
Provider Type
Individual
Full Name
Clark, Amy
Credential
LPCC

Gender
Female
Sole Proprietor
No
Enumeration Date
4/10/2015
Last Updated
4/10/2015

Contact Information

Practice Location

7459 Burlington Pike, Florence, KY 41042-1553

(859) 331-3292

(859) 578-2864

Mailing Location

502 Farrell Dr, Covington, KY 41011-3717

(859) 578-3204

(859) 578-3273

Provider Taxonomies

Code	Description	License
Code 101YP2500X Primary	Description Counselor Behavioral Health & Social Service Providers	License 1339 Kentucky

Provider Identifiers

ID	Description	Issuer
ID 610661458	Description Other	Issuer TAX ID Kentucky

Amy Clark

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Guerin, Suzanne Lemere

Northern Kentucky Behavioral Health

Patel, Mehul K

Fodi Gillespie, Kristen

Hutson, Katie Sue

Samantha Avis Counseling Llc

Gilbert, Haley

Avis, Samantha Ann

Vickers, Lesley

Mcdonald, Stephanie M