Provider Demographics
NPI:1447735980
Name:AMBER D'S LLC
Entity Type:Organization
Organization Name:AMBER D'S LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:WORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:502-536-7187
Mailing Address - Street 1:214 BRECKENRIDGE LN STE 205
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-3879
Mailing Address - Country:US
Mailing Address - Phone:502-536-7187
Mailing Address - Fax:
Practice Address - Street 1:214 BRECKENRIDGE LN STE 205
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-3879
Practice Address - Country:US
Practice Address - Phone:502-536-7187
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty