Provider Demographics
NPI:1114577137
Name:NORVILLE, AMBER NICHOLE (LCSW, CCFP, CIMHP)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:NICHOLE
Last Name:NORVILLE
Suffix:
Gender:F
Credentials:LCSW, CCFP, CIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 BUCKEYSTOWN PIKE STE 250
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21704-8344
Mailing Address - Country:US
Mailing Address - Phone:910-367-5355
Mailing Address - Fax:
Practice Address - Street 1:5100 BUCKEYSTOWN PIKE STE 250
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21704-8344
Practice Address - Country:US
Practice Address - Phone:910-367-5355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-12
Last Update Date:2024-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
180431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty