Provider Demographics
NPI:1073217741
Name:AMBER COLT COUNSELING LLC
Entity Type:Organization
Organization Name:AMBER COLT COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:M
Authorized Official - Last Name:COLT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:317-868-9974
Mailing Address - Street 1:1579 SPRINGMILL PONDS CIR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-8552
Mailing Address - Country:US
Mailing Address - Phone:317-868-9974
Mailing Address - Fax:317-663-2927
Practice Address - Street 1:11495 N PENN ST STE 126
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-6804
Practice Address - Country:US
Practice Address - Phone:317-868-9974
Practice Address - Fax:317-663-2927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)