Provider Demographics
NPI:1629447420
Name:ARMBRUSTER, PEGGY (LISW)
Entity type:Individual
Prefix:
First Name:PEGGY
Middle Name:
Last Name:ARMBRUSTER
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7555 HERITAGE WAY
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:OH
Mailing Address - Zip Code:44001-9800
Mailing Address - Country:US
Mailing Address - Phone:440-427-4058
Mailing Address - Fax:440-967-9436
Practice Address - Street 1:921 STATE ST
Practice Address - Street 2:
Practice Address - City:VERMILION
Practice Address - State:OH
Practice Address - Zip Code:44089-1203
Practice Address - Country:US
Practice Address - Phone:440-427-4058
Practice Address - Fax:440-967-9436
Is Sole Proprietor?:No
Enumeration Date:2015-09-22
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.2405820104100000X
OHI24058201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker