Provider Demographics
NPI:1265920367
Name:SMITH, AMBER LEIGH (LSW)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:LEIGH
Last Name:SMITH
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 MORGANTOWN STREET
Mailing Address - Street 2:SUITE 7000
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-4878
Mailing Address - Country:US
Mailing Address - Phone:724-557-6598
Mailing Address - Fax:724-550-4160
Practice Address - Street 1:315 MORGANTOWN STREET
Practice Address - Street 2:SUITE 7000
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-4878
Practice Address - Country:US
Practice Address - Phone:724-557-6598
Practice Address - Fax:724-550-4160
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-25
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW125446104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker