Individual
AMY HEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
1407 E 5TH ST, LUMBERTON, NC 28358-6007
(910) 739-6624
Mailing address
PO BOX 963, LUMBERTON, NC 28359-0963
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
141VX
BCBS
NC
05
—
6002845
—
NC
Enumeration date
02/16/2007
Last updated
07/08/2007
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