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General NPI Number Information
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NPI Number | 1679505390
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Entity Type | Individual
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Provider Name | AMBERLY EDGLEY KINCAID BCD, LISW, QMPH
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Gender | Female
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 511 N FORT THOMAS AVE
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City | FORT THOMAS
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State | KY
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Zip | 41075-1505
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Country | US
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Telephone | 859-653-0588
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Fax |
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Provider Business Mailing Address
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Address Line | 511 N FORT THOMAS AVE
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City | FORT THOMAS
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State | KY
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Zip | 41075-1505
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Country | US
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Telephone | 859-653-0588
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 60486
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 3284
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License Number State | KY
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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 | I.1201475
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License Number State | OH
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