Provider Demographics
NPI:1912148081
Name:DUMAS, AMBER K (MSSA, LISW)
Entity Type:Individual
Prefix:MS
First Name:AMBER
Middle Name:K
Last Name:DUMAS
Suffix:
Gender:F
Credentials:MSSA, LISW
Other - Prefix:MS
Other - First Name:AMBER
Other - Middle Name:K
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSSA, LISW
Mailing Address - Street 1:8300 HOUGH AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103-4247
Mailing Address - Country:US
Mailing Address - Phone:216-231-7700
Mailing Address - Fax:216-231-7920
Practice Address - Street 1:8300 HOUGH AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-4247
Practice Address - Country:US
Practice Address - Phone:216-231-7700
Practice Address - Fax:216-231-7920
Is Sole Proprietor?:No
Enumeration Date:2009-03-18
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 1100070-S1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH438170Medicare PIN
OHH438171Medicare PIN