Provider Demographics
NPI:1548352693
Name:CADICK, AMBER LEE (PHD)
Entity type:Individual
Prefix:DR
First Name:AMBER
Middle Name:LEE
Last Name:CADICK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 N 7TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47807-1061
Mailing Address - Country:US
Mailing Address - Phone:812-238-7631
Mailing Address - Fax:812-238-7003
Practice Address - Street 1:1530 N 7TH ST STE 201
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47807-1061
Practice Address - Country:US
Practice Address - Phone:812-238-7631
Practice Address - Fax:812-238-7003
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
IN20042236A103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health