Basic Information
| Provider Information | |||||||||
| NPI: | 1457538761 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KORSCH | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | MSSA, LISW-S | ||||||||
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| Mailing Information | |||||||||
| Address1: | 41 E ERIE ST | ||||||||
| Address2: | LOWER LEVEL | ||||||||
| City: | PAINESVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440773947 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4403587370 | ||||||||
| FaxNumber: | 4403587373 | ||||||||
| Practice Location | |||||||||
| Address1: | 41 E ERIE ST | ||||||||
| Address2: | LOWER LEVEL | ||||||||
| City: | PAINESVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440773947 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4403587370 | ||||||||
| FaxNumber: | 4403587373 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/29/2008 | ||||||||
| LastUpdateDate: | 01/29/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | I 0031572-S | OH | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.