Healthcare Provider Details

I. General information

NPI: 1285222117
Provider Name (Legal Business Name): AMBER LEWIS GOLDEN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMBER NICOLE LEWIS

II. Dates (important events)

Enumeration Date: 01/06/2021
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4337 COX RD
GLEN ALLEN VA
23060-3359
US

IV. Provider business mailing address

8401 MAYLAND DR STE S
RICHMOND VA
23294-4648
US

V. Phone/Fax

Practice location:
  • Phone: 804-277-9877
  • Fax:
Mailing address:
  • Phone: 804-592-6210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number17-175
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701010191
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: