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General NPI Number Information
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NPI Number | 1063284255
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Entity Type | Individual
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Provider Name | AMBER NICOLE RANSOM MA, LPC
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Gender | Female
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Dates
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Enumeration Date | 10/23/2023
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Last Update Date | 12/29/2023
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Provider Practice Location Address
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Address Line | 255 S 17TH ST FL 9
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City | PHILADELPHIA
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State | PA
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Zip | 19103-6209
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Country | US
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Telephone | 910-916-3050
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Fax |
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Provider Business Mailing Address
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Address Line | 5 KERN ST
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City | COLLINGDALE
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State | PA
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Zip | 19023-1902
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Country | US
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Telephone | 910-916-3050
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225600000X
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Taxonomy Name | Dance Therapist
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License Number | R-DMT-2622
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC015700
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License Number State | PA
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