Provider Demographics
NPI:1578155511
Name:CAIN, AMBER A (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:A
Last Name:CAIN
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5031 SPRINGFIELD AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19143-4223
Mailing Address - Country:US
Mailing Address - Phone:267-401-8199
Mailing Address - Fax:
Practice Address - Street 1:1720 N 62ND ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19151-3435
Practice Address - Country:US
Practice Address - Phone:267-401-8199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-10
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker