Provider Demographics
NPI:1235316357
Name:CAIN, AMY ELIZABETH (LPC)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:ELIZABETH
Last Name:CAIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:841 N POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:KS
Mailing Address - Zip Code:66030-1793
Mailing Address - Country:US
Mailing Address - Phone:913-530-7001
Mailing Address - Fax:
Practice Address - Street 1:13839 S MUR LEN RD
Practice Address - Street 2:SUITE K
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1652
Practice Address - Country:US
Practice Address - Phone:913-764-5463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-31
Last Update Date:2008-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1952101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional