Provider Demographics
NPI:1255594024
Name:OLIVER, AMBER J (LMSW)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:J
Last Name:OLIVER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 LEILANIS LN
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:13815-3540
Mailing Address - Country:US
Mailing Address - Phone:607-337-1680
Mailing Address - Fax:
Practice Address - Street 1:105 LEILANIS LN
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815-3540
Practice Address - Country:US
Practice Address - Phone:607-337-1680
Practice Address - Fax:607-334-4519
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY080667-11041C0700X
101YM0800X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)