Healthcare Provider Details

I. General information

NPI: 1710816897
Provider Name (Legal Business Name): AMBER BARRERO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 W GRANADA BLVD STE B8
ORMOND BEACH FL
32174-9490
US

IV. Provider business mailing address

20 SPINNAKER CIR
SOUTH DAYTONA FL
32119-8550
US

V. Phone/Fax

Practice location:
  • Phone: 386-473-1688
  • Fax:
Mailing address:
  • Phone: 618-409-6966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number23517
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: