Provider Demographics
NPI:1902138688
Name:MASSINGILL, AMY FLETCHER (LPC)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:FLETCHER
Last Name:MASSINGILL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 SCOTLAND RD
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640-9211
Mailing Address - Country:US
Mailing Address - Phone:864-304-2643
Mailing Address - Fax:864-855-5758
Practice Address - Street 1:1737 POWDERSVILLE RD
Practice Address - Street 2:C-4
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29642-8057
Practice Address - Country:US
Practice Address - Phone:864-304-2643
Practice Address - Fax:864-855-5758
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4737101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional