Healthcare Provider Details

I. General information

NPI: 1306550561
Provider Name (Legal Business Name): AMBER L MIURA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2023
Last Update Date: 07/11/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2255 SHERIDAN BLVD
DENVER CO
80214
US

IV. Provider business mailing address

19917 VICTORIAN WAY
PARKER CO
80138-3802
US

V. Phone/Fax

Practice location:
  • Phone: 720-575-9889
  • Fax:
Mailing address:
  • Phone: 720-575-9889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC.00200320
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0020320
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: