Healthcare Provider Details

I. General information

NPI: 1013651330
Provider Name (Legal Business Name): AMBER BAXTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2022
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 YOUNGSTOWN POLAND RD
STRUTHERS OH
44471-1103
US

IV. Provider business mailing address

2980 BELMONT AVE
YOUNGSTOWN OH
44505-1834
US

V. Phone/Fax

Practice location:
  • Phone: 330-318-3078
  • Fax: 234-855-1072
Mailing address:
  • Phone: 330-759-0276
  • Fax: 330-759-0030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.2406336-TRNE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: