MEDICARE: AMBER FAULHABER LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW26363	FL

General Provider Information

NPI Number	:	1376487488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER FAULHABER LCSW

Provider Business Mailing Address
First Line	:	4300 MARSH LANDING BLVD STE 101
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-1419
Country	:	US
Telephone Number	:	904-686-8055
Fax Number	:	904-686-8105

Provider Business Practice Location Address
First Line	:	4300 MARSH LANDING BLVD STE 101
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-1419
Country	:	US
Telephone Number	:	904-686-8055
Fax Number	:	904-686-8105

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2026
Last Update Date	:	04/17/2026

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