Basic Information
| Provider Information | |||||||||
| NPI: | 1336758994 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COMPTON | ||||||||
| FirstName: | AMY | ||||||||
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| Credential: | LLMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 22490 BAYVIEW DR | ||||||||
| Address2: | |||||||||
| City: | SAINT CLAIR SHORES | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480812408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9895452928 | ||||||||
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| Practice Location | |||||||||
| Address1: | 19611 E 8 MILE RD | ||||||||
| Address2: | |||||||||
| City: | SAINT CLAIR SHORES | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480801655 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5865419550 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2020 | ||||||||
| LastUpdateDate: | 07/29/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 6801107020 | MI | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.