Healthcare Provider Details

I. General information

NPI: 1669115721
Provider Name (Legal Business Name): ALLISON AMBLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2022
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 BANNOCK ST
DENVER CO
80204-4597
US

IV. Provider business mailing address

601 N BROADWAY # MC1926
DENVER CO
80203-3407
US

V. Phone/Fax

Practice location:
  • Phone: 303-436-4949
  • Fax:
Mailing address:
  • Phone: 303-436-4949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09931780
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6084C
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: