Provider Demographics
NPI:1174642565
Name:UJIFUSA, AMY BROOKS (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:BROOKS
Last Name:UJIFUSA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 GREENRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-1303
Mailing Address - Country:US
Mailing Address - Phone:914-666-7132
Mailing Address - Fax:
Practice Address - Street 1:333 ADAMS ST
Practice Address - Street 2:
Practice Address - City:BEDFORD HILLS
Practice Address - State:NY
Practice Address - Zip Code:10507-2001
Practice Address - Country:US
Practice Address - Phone:914-242-0725
Practice Address - Fax:914-242-5152
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR051481-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical