Provider Demographics
NPI:1326536780
Name:CUFFE, AMBER (CERTIFIED COUNSELOR)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:CUFFE
Suffix:
Gender:F
Credentials:CERTIFIED COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4125 S SETTLER DR APT 152
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:WA
Mailing Address - Zip Code:98642-5496
Mailing Address - Country:US
Mailing Address - Phone:206-376-3648
Mailing Address - Fax:
Practice Address - Street 1:4125 S SETTLER DR APT 152
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:WA
Practice Address - Zip Code:98642-5496
Practice Address - Country:US
Practice Address - Phone:206-376-3648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-01
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACL61046444101Y00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1326536780Medicaid