MEDICARE: AMBER M VINSON, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1235896374
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMBER M VINSON, LLC

Provider Business Mailing Address
First Line	:	1188 BISHOP ST STE 2201
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96813-3309
Country	:	US
Telephone Number	:	808-861-0686
Fax Number	:

Provider Business Practice Location Address
First Line	:	1188 BISHOP ST STE 2201
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96813-3309
Country	:	US
Telephone Number	:	808-861-0686
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	AMBER M VINSON
Credential	:	LMFT
Telephone Number	:	808-861-0686

Provider Enumeration Date	:	11/23/2021
Last Update Date	:	02/17/2025

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