Basic Information
Provider Information
NPI: 1992011159
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUFF
FirstName: AMBER
MiddleName: LYNN
NamePrefix:  
NameSuffix:  
Credential: LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 620 COURT ST
Address2: 5TH FLOOR
City: LYNCHBURG
State: VA
PostalCode: 245041312
CountryCode: US
TelephoneNumber: 4344858861
FaxNumber: 4344858877
Practice Location
Address1: 620 COURT ST
Address2: 5TH FLOOR
City: LYNCHBURG
State: VA
PostalCode: 245041312
CountryCode: US
TelephoneNumber: 4344858861
FaxNumber: 4344858877
Other Information
ProviderEnumerationDate: 08/26/2010
LastUpdateDate: 08/26/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X0701004868VAY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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