Provider Demographics
NPI:1114577137
Name:NORVILLE, AMBER NICHOLE (LCSW, CCFP, CIMHP)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:NICHOLE
Last Name:NORVILLE
Suffix:
Gender:F
Credentials:LCSW, CCFP, CIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 N FRONT ST STE 157
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-3920
Mailing Address - Country:US
Mailing Address - Phone:910-367-5355
Mailing Address - Fax:
Practice Address - Street 1:226 N FRONT ST STE 157
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-3920
Practice Address - Country:US
Practice Address - Phone:910-367-5355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-12
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
P0140651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty