=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508574161
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMBER FRANCIS CAS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/11/2022
-----------------------------------------------------
Last Update Date | 02/09/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 313 S 5TH ST STE 7
-----------------------------------------------------
City | LAMAR
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 81052-2773
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 855-787-4243
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7861 COUNTY HIGHWAY 196
-----------------------------------------------------
City | LAMAR
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 81052-9645
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-688-7697
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number | ACC.0021125
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------