Provider Demographics
NPI:1801230099
Name:THOMASON, AMBER MARIE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:MARIE
Last Name:THOMASON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 S BROADWAY # 7
Mailing Address - Street 2:
Mailing Address - City:PITMAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08071-2235
Mailing Address - Country:US
Mailing Address - Phone:844-365-7676
Mailing Address - Fax:844-365-7676
Practice Address - Street 1:140 S BROADWAY # 7
Practice Address - Street 2:
Practice Address - City:PITMAN
Practice Address - State:NJ
Practice Address - Zip Code:08071-2235
Practice Address - Country:US
Practice Address - Phone:844-365-7676
Practice Address - Fax:844-365-7676
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor