Provider Demographics
NPI:1922336080
Name:KING, AMBER ELIZABETH (MSW, LMHP)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:ELIZABETH
Last Name:KING
Suffix:
Gender:F
Credentials:MSW, LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15060 DAYTON ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-5100
Mailing Address - Country:US
Mailing Address - Phone:402-813-1445
Mailing Address - Fax:
Practice Address - Street 1:11836 ARBOR ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-2941
Practice Address - Country:US
Practice Address - Phone:402-898-8881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-01
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8719101Y00000X
NE66521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor