=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356278014
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMBER ANN HAXTON LMSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/06/2026
-----------------------------------------------------
Last Update Date | 05/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 90B PULTENEY ST
-----------------------------------------------------
City | HAMMONDSPORT
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14840-9320
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-610-7481
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 147 TERRY ST
-----------------------------------------------------
City | HORNELL
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14843-2007
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-610-7481
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 131281
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------