Provider Demographics
NPI:1023255122
Name:EARNHEART, AMY M (LCSW)
Entity type:Individual
Prefix:MISS
First Name:AMY
Middle Name:M
Last Name:EARNHEART
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28714-2925
Mailing Address - Country:US
Mailing Address - Phone:828-208-4885
Mailing Address - Fax:828-682-2119
Practice Address - Street 1:10 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28714-2925
Practice Address - Country:US
Practice Address - Phone:828-536-0391
Practice Address - Fax:828-682-2119
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-11
Last Update Date:2024-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1476101YA0400X
NCC0059701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6007209Medicaid