Provider Demographics
NPI:1821509175
Name:ARIEMMA, AMBER (LCPC)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:ARIEMMA
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30537 POTOMAC WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE HALL
Mailing Address - State:MD
Mailing Address - Zip Code:20622-3180
Mailing Address - Country:US
Mailing Address - Phone:443-295-3278
Mailing Address - Fax:
Practice Address - Street 1:30537 POTOMAC WAY STE 101
Practice Address - Street 2:
Practice Address - City:CHARLOTTE HALL
Practice Address - State:MD
Practice Address - Zip Code:20622-3180
Practice Address - Country:US
Practice Address - Phone:443-295-3278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-13
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC7022101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health