Provider Demographics
NPI:1043336159
Name:BABINEAU, AMY C (LMHC)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:C
Last Name:BABINEAU
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 WASHINGTON ST
Mailing Address - Street 2:SUITE 510
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-3330
Mailing Address - Country:US
Mailing Address - Phone:315-782-4483
Mailing Address - Fax:315-785-9210
Practice Address - Street 1:120 WASHINGTON ST
Practice Address - Street 2:SUITE 510
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-3330
Practice Address - Country:US
Practice Address - Phone:315-782-4483
Practice Address - Fax:315-785-9210
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4546101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA4546OtherALLIED MENTAL HEALTH