Provider Demographics
NPI:1508585738
Name:LAVARE, AMBER ELIZABETH (LMSW)
Entity Type:Individual
Prefix:MISS
First Name:AMBER
Middle Name:ELIZABETH
Last Name:LAVARE
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 1:232 UPPER MANNIX RD
Mailing Address - Street 2:
Mailing Address - City:EAST GREENBUSH
Mailing Address - State:NY
Mailing Address - Zip Code:12061-4122
Mailing Address - Country:US
Mailing Address - Phone:518-419-8571
Mailing Address - Fax:
Practice Address - Street 1:232 UPPER MANNIX RD
Practice Address - Street 2:
Practice Address - City:EAST GREENBUSH
Practice Address - State:NY
Practice Address - Zip Code:12061-4122
Practice Address - Country:US
Practice Address - Phone:518-419-8571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY114638104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker