Basic Information
| Provider Information | |||||||||
| NPI: | 1154870269 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TUNNEY | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 116 | ||||||||
| Address2: | |||||||||
| City: | BLUE HILL | ||||||||
| State: | ME | ||||||||
| PostalCode: | 046140116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2072664710 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6 MINES RD STE D | ||||||||
| Address2: | |||||||||
| City: | BLUE HILL | ||||||||
| State: | ME | ||||||||
| PostalCode: | 046146408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 0726647102 | ||||||||
| FaxNumber: | 5084331871 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/30/2016 | ||||||||
| LastUpdateDate: | 01/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LC17581 | ME | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.