Healthcare Provider Details

I. General information

NPI: 1528424496
Provider Name (Legal Business Name): AMBER DAVIS LGSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2016
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 M ST SE STE 667
WASHINGTON DC
20003-3519
US

IV. Provider business mailing address

220 GRANT AVE
TAKOMA PARK MD
20912-4234
US

V. Phone/Fax

Practice location:
  • Phone: 202-749-8630
  • Fax:
Mailing address:
  • Phone: 407-470-9169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLG50081129
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: