Provider Demographics
NPI:1992084966
Name:ZYCH, AMBER R (L-CSW)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:R
Last Name:ZYCH
Suffix:
Gender:F
Credentials:L-CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 HERITAGE DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:NY
Mailing Address - Zip Code:14086-1022
Mailing Address - Country:US
Mailing Address - Phone:716-683-6544
Mailing Address - Fax:
Practice Address - Street 1:34 HERITAGE DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:NY
Practice Address - Zip Code:14086-1022
Practice Address - Country:US
Practice Address - Phone:716-683-6544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR047082-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical