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General NPI Number Information
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NPI Number | 1184374142
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Entity Type | Individual
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Provider Name | AMBER PATRICE WOODWARD LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/24/2022
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 68 LONG MEADOW AVE
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City | HAMDEN
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State | CT
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Zip | 06514-4330
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Country | US
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Telephone | 214-734-3132
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Fax | 203-785-0617
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Provider Business Mailing Address
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Address Line | 68 LONG MEADOW AVE
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City | HAMDEN
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State | CT
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Zip | 06514-4330
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Country | US
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Telephone | 214-734-3132
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Fax | 203-785-0617
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 55759
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225A00000X
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Taxonomy Name | Music Therapist
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License Number | MUS.000039
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 58.014660
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License Number State | CT
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