Foster, Amy Diachenko

Foster, Amy Diachenko is an sole proprietor health care provider with primary practice located at 2554 Lewisville Clemmons Rd Ste 303 , Clemmons NC 27012-8749. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Foster, Amy Diachenko can be contacted via phone (336) 849-7890.

Contact Information

Primary practice address
2554 Lewisville Clemmons Rd Ste 303 Clemmons NC 27012-8749
Phone: (336) 849-7890
Fax: (336) 223-5060
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X
Behavioral Health & Social Service Providers / Clinical 103TC0700X 3555 North Carolina
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 3555 North Carolina
Behavioral Health & Social Service Providers / Psychologist 103T00000X 3555 North Carolina

Profile Details

NPI number 1144432246
LBN Legal business name Foster, Amy Diachenko
Credentials Master of Arts (MA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 3rd, 2007
Last updated Aug 31st, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144432246 NPPES
North Carolina MEDICAID 6107576

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