# AMY BREESE, LICSW, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013594662
- **Authorized official:** AMY BREESE LICSW (PROVIDER)
- **Authorized official phone:** (518) 469-8704

## Contact information

- **Practice address:** 937 GAGE ST, BENNINGTON, VT 05201-2069
- **Practice address phone:** (518) 469-8704
- **Mailing address:** 937 GAGE ST, BENNINGTON, VT 05201-2069
- **Mailing address phone:** (518) 469-8704

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 03/28/2021
- **Last updated:** 03/28/2021
