Provider Demographics
NPI:1194226670
Name:CROSBY, AMBER LEE (MSW, LISW)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:LEE
Last Name:CROSBY
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3523 6TH AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50313-4140
Mailing Address - Country:US
Mailing Address - Phone:515-494-1024
Mailing Address - Fax:
Practice Address - Street 1:3523 6TH AVE STE 103
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50313-4140
Practice Address - Country:US
Practice Address - Phone:515-494-1024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-21
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA104100000X
IA0077241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker