MEDICARE: AMBERLIN SALAS M.A., LPC

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	101YM0800X	Mental Health Counselor	86986	TX

General Provider Information

NPI Number	:	1922712181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBERLIN SALAS M.A., LPC

Provider Business Mailing Address
First Line	:	5900 BALCONES DR STE 100
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78731-4298
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9285 HUNTINGTON SQ
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76182-4366
Country	:	US
Telephone Number	:	512-693-7519
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2023
Last Update Date	:	09/30/2024

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