Provider Demographics
NPI:1376046250
Name:COCCHIOLA, AMBER STILLEY (LCSW)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:STILLEY
Last Name:COCCHIOLA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:ROSE
Other - Last Name:STILLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30108 HUBERT STILLEY RD
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:LA
Mailing Address - Zip Code:70443-3604
Mailing Address - Country:US
Mailing Address - Phone:225-235-4136
Mailing Address - Fax:
Practice Address - Street 1:15790 PAUL VEGA DR
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1434
Practice Address - Country:US
Practice Address - Phone:985-230-7620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-16
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA94801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical