Provider Demographics
NPI:1154729275
Name:LOSSING, AMBER LEIGH (LMSW)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:LEIGH
Last Name:LOSSING
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:LEIGH MARIE
Other - Last Name:HICKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 34
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-0034
Mailing Address - Country:US
Mailing Address - Phone:313-930-7044
Mailing Address - Fax:
Practice Address - Street 1:1 HERITAGE DR STE 520
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-3051
Practice Address - Country:US
Practice Address - Phone:248-483-0530
Practice Address - Fax:248-605-3525
Is Sole Proprietor?:No
Enumeration Date:2014-12-06
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010975501041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical