Provider Demographics
NPI:1629200530
Name:CAIN-CRAIGMILE, AMBER M (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:M
Last Name:CAIN-CRAIGMILE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:AMBER
Other - Middle Name:M
Other - Last Name:CAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:106 CLEVELAND BLVD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13066
Mailing Address - Country:US
Mailing Address - Phone:315-955-5417
Mailing Address - Fax:
Practice Address - Street 1:2100 E GENESEE ST.
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210
Practice Address - Country:US
Practice Address - Phone:315-955-5417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-12
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP72129OtherPERMIT