Healthcare Provider Details

I. General information

NPI: 1780223537
Provider Name (Legal Business Name): AMBER MARIE HELMAN LGPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2019
Last Update Date: 12/26/2019
Certification Date: 12/26/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 PLEASANT RIDGE DR STE H
OWINGS MILLS MD
21117-2560
US

IV. Provider business mailing address

7404 PARK HEIGHTS AVE
BALTIMORE MD
21208-5201
US

V. Phone/Fax

Practice location:
  • Phone: 410-705-0664
  • Fax:
Mailing address:
  • Phone: 864-396-3294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLGP10092
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License NumberLGP10092
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGP10092
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: