Provider Demographics
NPI:1598030447
Name:ADAMS, AMBER MAE (LCSW)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:MAE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4190 S HIGHLAND DR STE 220
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-2675
Mailing Address - Country:US
Mailing Address - Phone:801-558-9005
Mailing Address - Fax:866-923-8389
Practice Address - Street 1:4190 S HIGHLAND DR STE 220
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-2675
Practice Address - Country:US
Practice Address - Phone:801-558-9005
Practice Address - Fax:866-923-8389
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-11
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW-13481041C0700X
UT7456923-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical