Provider Demographics
NPI:1073393740
Name:WINKLE, AMBER NICOLE (LMSW)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:NICOLE
Last Name:WINKLE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:N
Other - Last Name:PALMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 CUSHMAN ST STE 308
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-4673
Mailing Address - Country:US
Mailing Address - Phone:850-376-1456
Mailing Address - Fax:
Practice Address - Street 1:1100 WILFORD HALL LOOP
Practice Address - Street 2:
Practice Address - City:JBSA LACKLAND
Practice Address - State:TX
Practice Address - Zip Code:78236-5638
Practice Address - Country:US
Practice Address - Phone:210-292-7361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-02
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK207863104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker