Healthcare Provider Details

I. General information

NPI: 1750832978
Provider Name (Legal Business Name): AMBER COTE MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMBER SANTACROCE

II. Dates (important events)

Enumeration Date: 10/24/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 S WALNUT ST SUITE D
WAUREGAN CT
06387
US

IV. Provider business mailing address

PO BOX 86
HARMONY RI
02829-0086
US

V. Phone/Fax

Practice location:
  • Phone: 860-771-9989
  • Fax:
Mailing address:
  • Phone:
  • 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 Code101YP2500X
TaxonomyProfessional Counselor
License Number3570
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: