Provider Demographics
NPI:1558194548
Name:EBRIGHT, AMBER (LSW)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:EBRIGHT
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 TURKEY VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:PA
Mailing Address - Zip Code:17045-8247
Mailing Address - Country:US
Mailing Address - Phone:570-495-6404
Mailing Address - Fax:
Practice Address - Street 1:632 MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:PA
Practice Address - Zip Code:17086
Practice Address - Country:US
Practice Address - Phone:717-856-0220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW141034104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker