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NPI Code Detail

MEDICARE: AMBER MCKENZIE LPC

MEDICARE:   AMBER  MCKENZIE  LPC
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1902929417
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER MCKENZIE LPC
Provider Business Mailing Address
First Line : 110 SKYLINE DR
Second Line :
City : RUSSELLVILLE
State : AR
Zip : 72801-3362
Country : US
Telephone Number : 479-967-5570
Fax Number : 479-890-5364
Provider Business Practice Location Address
First Line : 350 SALEM RD STE 1
Second Line :
City : CONWAY
State : AR
Zip : 72034-6166
Country : US
Telephone Number : 501-336-8300
Fax Number : 501-329-5508
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2007
Last Update Date : 06/22/2010

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Directions to “ AMBER MCKENZIE LPC” Practice Location

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