Provider Demographics
NPI:1902244767
Name:DEERING, AMBER CHRISTINE (LLPC, ATR)
Entity Type:Individual
Prefix:MISS
First Name:AMBER
Middle Name:CHRISTINE
Last Name:DEERING
Suffix:
Gender:F
Credentials:LLPC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3411 WILLOW LAKE DR APT 204
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-2600
Mailing Address - Country:US
Mailing Address - Phone:269-873-7347
Mailing Address - Fax:
Practice Address - Street 1:491 COLUMBIA AVE E STE 4
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49014-5468
Practice Address - Country:US
Practice Address - Phone:269-962-9611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-13
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012274101Y00000X
MI12195101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional