Provider Demographics
NPI:1194415174
Name:DOBY, AMBER JOY (LCSWA)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:JOY
Last Name:DOBY
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3016 W GREENSBORO CHAPEL HILL RD
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:NC
Mailing Address - Zip Code:27298-9073
Mailing Address - Country:US
Mailing Address - Phone:336-263-5679
Mailing Address - Fax:
Practice Address - Street 1:1205 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-5762
Practice Address - Country:US
Practice Address - Phone:336-901-2998
Practice Address - Fax:336-513-0554
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-11
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0188031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1194415174Medicaid