Provider Demographics
NPI:1265868251
Name:SLADE, AMBER DENICE (MSW)
Entity type:Individual
Prefix:MS
First Name:AMBER
Middle Name:DENICE
Last Name:SLADE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:DENICE
Other - Last Name:ALEXANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4006 EMBERS LNDG
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32505-3434
Mailing Address - Country:US
Mailing Address - Phone:850-454-6592
Mailing Address - Fax:
Practice Address - Street 1:6001 W NINE MILE RD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32526-5252
Practice Address - Country:US
Practice Address - Phone:850-454-6592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-23
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
FLSW137381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical