Provider Demographics
NPI:1033664560
Name:VAMBRECK, JAMES (LICSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:VAMBRECK
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4849 CONNECTICUT AVE NW
Mailing Address - Street 2:APT. 923
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-5853
Mailing Address - Country:US
Mailing Address - Phone:202-841-8875
Mailing Address - Fax:
Practice Address - Street 1:1905 E ST SE
Practice Address - Street 2:BLDG. 14
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-2593
Practice Address - Country:US
Practice Address - Phone:202-673-9300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500785221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical