Basic Information
| Provider Information | |||||||||
| NPI: | 1598362444 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SPARROW | ||||||||
| FirstName: | AMBER | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11279 PERRY HWY STE 450 | ||||||||
| Address2: | |||||||||
| City: | WEXFORD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150909303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7249331100 | ||||||||
| FaxNumber: | 7249331160 | ||||||||
| Practice Location | |||||||||
| Address1: | 1220 LINCOLN WAY | ||||||||
| Address2: | |||||||||
| City: | WHITE OAK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151311642 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126732200 | ||||||||
| FaxNumber: | 4126733205 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2020 | ||||||||
| LastUpdateDate: | 10/05/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | PC011705 | PA | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.