Provider Demographics
NPI:1952154189
Name:WESTERBURG, AMELIA (LCSW)
Entity Type:Individual
Prefix:
First Name:AMELIA
Middle Name:
Last Name:WESTERBURG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-7106
Mailing Address - Country:US
Mailing Address - Phone:318-355-1415
Mailing Address - Fax:
Practice Address - Street 1:800 CLAIBORNE ST
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-2612
Practice Address - Country:US
Practice Address - Phone:318-432-5400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA167841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical