Provider Demographics
NPI:1083271449
Name:HELLSTRAND, AMBER (CSW)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:HELLSTRAND
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2240 N HWY 89 STE C
Mailing Address - Street 2:
Mailing Address - City:HARRISVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84404-2824
Mailing Address - Country:US
Mailing Address - Phone:801-393-6232
Mailing Address - Fax:801-393-4081
Practice Address - Street 1:2240 N HWY 89 STE C
Practice Address - Street 2:
Practice Address - City:HARRISVILLE
Practice Address - State:UT
Practice Address - Zip Code:84404-2824
Practice Address - Country:US
Practice Address - Phone:801-393-6232
Practice Address - Fax:801-393-4081
Is Sole Proprietor?:No
Enumeration Date:2019-05-21
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5191171-3502101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor