Provider Demographics
NPI:1467809285
Name:WHITE, AMBER
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06795-2758
Mailing Address - Country:US
Mailing Address - Phone:860-307-7930
Mailing Address - Fax:
Practice Address - Street 1:8 ATWOOD DR
Practice Address - Street 2:SUITE 301
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-4266
Practice Address - Country:US
Practice Address - Phone:413-773-1314
Practice Address - Fax:413-774-1197
Is Sole Proprietor?:No
Enumeration Date:2016-05-23
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker