Provider Demographics
NPI:1891161121
Name:DONAHUE, AMBER (LMSW)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:DONAHUE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:DONAHUE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:4111 ANDOVER RD STE 150-W
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48302-1909
Mailing Address - Country:US
Mailing Address - Phone:248-629-0016
Mailing Address - Fax:
Practice Address - Street 1:4111 ANDOVER RD STE 150-W
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48302-1909
Practice Address - Country:US
Practice Address - Phone:248-629-0016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-20
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801109568104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical