Provider Demographics
NPI:1518484369
Name:COLLINS, AMBER MARIE (TCADC)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:MARIE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:TCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 KINGS DAUGHTERS DR STE 400
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-4242
Mailing Address - Country:US
Mailing Address - Phone:502-699-2885
Mailing Address - Fax:502-699-2890
Practice Address - Street 1:140 KINGS DAUGHTERS DR STE 400
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-4242
Practice Address - Country:US
Practice Address - Phone:859-498-6574
Practice Address - Fax:859-498-7325
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2022-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY174394101YA0400X
KY275542101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional