Provider Demographics
NPI:1538558531
Name:WILLIAMS, AMBER (LPCA)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CORYDON
Mailing Address - State:KY
Mailing Address - Zip Code:42406-9593
Mailing Address - Country:US
Mailing Address - Phone:270-779-4099
Mailing Address - Fax:
Practice Address - Street 1:230 2ND ST
Practice Address - Street 2:SUITE 406
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-3172
Practice Address - Country:US
Practice Address - Phone:270-854-3132
Practice Address - Fax:855-718-2663
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-13
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
KY1362101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical