Provider Demographics
NPI:1053684316
Name:MOLYNEUX, AMY J (LMSW)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:J
Last Name:MOLYNEUX
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 S STUART ST STE B
Mailing Address - Street 2:
Mailing Address - City:SIGOURNEY
Mailing Address - State:IA
Mailing Address - Zip Code:52591-1154
Mailing Address - Country:US
Mailing Address - Phone:641-622-1148
Mailing Address - Fax:641-210-6459
Practice Address - Street 1:1314 S STUART ST STE B
Practice Address - Street 2:
Practice Address - City:SIGOURNEY
Practice Address - State:IA
Practice Address - Zip Code:52591-1154
Practice Address - Country:US
Practice Address - Phone:641-622-1170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-17
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06705101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health