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Susan Blake Amory, CSW, LPC

Counselor, Professional in Cheyenne, WY. Individual provider (NPI-1).

NPI number1679975635
StatusActive
Last updated in NPPESJul 31, 2018

Details

NPI
1679975635
Entity type
Individual (NPI-1)
Name
Susan Blake Amory
Credential
CSW, LPC
Sex
Female
Sole proprietor
Yes
Enumeration date
Sep 22, 2014
Last updated
Jul 31, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YP2500X Counselor, Professional1725WYYes
1041C0700X Social Worker, Clinical235WY

Other names

  • Susan Blake Prendergrast (Former Name)

Practice location

300 E 17th St
Cheyenne, WY 82001

Phone 307-631-9931 · Fax 307-635-7706

Mailing address

1914 Thomes Ave
Cheyenne, WY 82001-3527

Phone 307-631-9931 · Fax 307-635-7706

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