Provider Demographics
NPI:1023315561
Name:AMOS, ASHLEY NICOLE (LCSW)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:NICOLE
Last Name:AMOS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:WARREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:37 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAST WORCESTER
Mailing Address - State:NY
Mailing Address - Zip Code:12064-2021
Mailing Address - Country:US
Mailing Address - Phone:607-435-6326
Mailing Address - Fax:
Practice Address - Street 1:37 MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST WORCESTER
Practice Address - State:NY
Practice Address - Zip Code:12064-2021
Practice Address - Country:US
Practice Address - Phone:607-435-6326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-18
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY081023-11041C0700X
NY078865104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker