Provider Demographics
NPI:1881879799
Name:JOHNSON, AMBER MARIA (PSYD)
Entity type:Individual
Prefix:DR
First Name:AMBER
Middle Name:MARIA
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:AMBER
Other - Middle Name:MARIA
Other - Last Name:SARPY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:1812 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-1103
Mailing Address - Country:US
Mailing Address - Phone:908-322-2050
Mailing Address - Fax:908-845-0249
Practice Address - Street 1:1812 FRONT ST
Practice Address - Street 2:
Practice Address - City:SCOTCH PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07076-1103
Practice Address - Country:US
Practice Address - Phone:908-322-2050
Practice Address - Fax:908-845-0249
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-09
Last Update Date:2009-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4493103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical