Provider Demographics
NPI:1497963565
Name:AMBER, KAREN STEWART (LMSW,ACSW)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:STEWART
Last Name:AMBER
Suffix:
Gender:F
Credentials:LMSW,ACSW
Other - Prefix:MRS
Other - First Name:KAREN
Other - Middle Name:STEWART
Other - Last Name:AMBER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW,ACSW
Mailing Address - Street 1:1501 SODON LAKE DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-2359
Mailing Address - Country:US
Mailing Address - Phone:248-765-1501
Mailing Address - Fax:248-851-8795
Practice Address - Street 1:1501 SODON LAKE DR
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-2359
Practice Address - Country:US
Practice Address - Phone:248-765-1501
Practice Address - Fax:248-851-8795
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801010264101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6801010264Medicare ID - Type UnspecifiedCERTIFIED SOCIAL WORKER