Healthcare Provider Details

I. General information

NPI: 1679172308
Provider Name (Legal Business Name): AMBER CHAMBERLAIN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2020
Last Update Date: 10/23/2020
Certification Date: 10/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N GLEBE RD
ARLINGTON VA
22203-3728
US

IV. Provider business mailing address

7046 DARBY TOWNE CT
ALEXANDRIA VA
22315-4752
US

V. Phone/Fax

Practice location:
  • Phone: 703-841-0703
  • Fax: 703-243-7956
Mailing address:
  • Phone: 301-775-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: