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General NPI Number Information
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NPI Number | 1972112944
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Entity Type | Organization
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Legal Business Name | COUNSELING OFFICE OF YOUNTINA AMBIS LLC
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Dates
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Enumeration Date | 07/27/2020
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Last Update Date | 09/16/2022
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Provider Practice Location Address
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Address Line | 4580 S EASTERN AVE STE 33
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City | LAS VEGAS
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State | NV
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Zip | 89119-6100
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Country | US
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Telephone | 702-241-2472
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Fax |
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Provider Business Mailing Address
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Address Line | 4580 S EASTERN AVE STE 33
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City | LAS VEGAS
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State | NV
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Zip | 89119-6100
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Country | US
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Telephone | 702-328-1986
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Fax | 702-825-2598
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Authorized Official
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Title or Position | OWNER/EMPLOYEE
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Name | YOUNTINA ANNE AMBIS
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Credential | LCSW, CADC, BCN
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Telephone | 702-328-1986
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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