Provider Demographics
NPI:1831238278
Name:DANGERVIL, AMBER J (LCSW)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:J
Last Name:DANGERVIL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:AMBER
Other - Middle Name:J
Other - Last Name:ROBERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:11929 80TH RD
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-1105
Mailing Address - Country:US
Mailing Address - Phone:347-566-2273
Mailing Address - Fax:
Practice Address - Street 1:11929 80TH RD
Practice Address - Street 2:
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-1105
Practice Address - Country:US
Practice Address - Phone:347-566-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0794861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical