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General NPI Number Information
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NPI Number | 1760336366
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Entity Type | Organization
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Legal Business Name | EMBER AND ASH INTEGRATIVE MENTAL HEALTH LLC
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Dates
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Enumeration Date | 02/23/2026
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Last Update Date | 02/23/2026
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Provider Practice Location Address
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Address Line | 1525 E REPUBLIC RD STE A130
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City | SPRINGFIELD
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State | MO
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Zip | 65804-6582
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Country | US
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Telephone | 417-880-9481
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Fax |
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Provider Business Mailing Address
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Address Line | 396 MAYNARD RD
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City | NIXA
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State | MO
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Zip | 65714-7267
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Country | US
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Telephone | 417-880-9481
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Fax | 417-855-8229
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | RIKI LEE CLARK
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Credential | PMHNP
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Telephone | 417-880-9481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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