Amy Lynn Bray, LMSW
Individual provider Active NPI Social Worker · Fenton, MI
NPI 1700215472 · NPPES record last updated Dec 15, 2017
Key facts
- NPI
- 1700215472
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 6801094551 (MI)
- Practice address
- 706 Park St
Fenton, MI 48430-2075 - Phone
- (810) 624-7258
- NPI assigned
- Nov 4, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801094551 | MI | Yes |
Addresses
Primary practice location
706 Park St
Fenton, MI 48430-2075
Mailing address
706 Park St
Fenton, MI 48430-2075
Phone (810) 624-7258
Other providers in Fenton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 15, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.