Willis, Amy J
Willis, Amy J is an individual health care provider with primary practice located at 2603 Osborne Rd Ste E , Saint Marys GA 31558-8907. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Willis, Amy J can be contacted via phone (912) 510-3420.Contact Information
Primary practice address
2603 Osborne Rd Ste E
Saint Marys GA 31558-8907
Phone: (912) 510-3420
Fax: (912) 510-3425
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | LSW0000004269 | Tennessee |
Profile Details
| NPI number | 1235229980 |
|---|---|
| LBN Legal business name | Willis, Amy J |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 13th, 2006 |
| Last updated | Jun 7th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235229980 | NPPES |
| Tennessee | MEDICAID | 3698356 |
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