MEDICARE: AMBER KINNEY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1083214159
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMBER KINNEY, LLC

Provider Business Mailing Address
First Line	:	819 E 64TH ST STE 240
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-1672
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	819 E 64TH ST STE 240
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-1672
Country	:	US
Telephone Number	:	--
Fax Number	:

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	AMBER KINNEY
Credential	:	LMHC
Telephone Number	:	--

Provider Enumeration Date	:	10/28/2020
Last Update Date	:	01/15/2025

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Directions to “AMBER KINNEY, LLC ” Practice Location

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