Provider Demographics
NPI:1497784292
Name:MCEACHERN, AMBER DEON (PHD)
Entity Type:Individual
Prefix:MS
First Name:AMBER
Middle Name:DEON
Last Name:MCEACHERN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 CARLISLE BLVD NE STE F
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-5667
Mailing Address - Country:US
Mailing Address - Phone:505-503-1959
Mailing Address - Fax:505-545-6701
Practice Address - Street 1:1400 CARLISLE BLVD NE STE F
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-5667
Practice Address - Country:US
Practice Address - Phone:505-503-1959
Practice Address - Fax:505-369-1851
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1016101YM0800X
NE8349101YM0800X
NMPSY1190103TC0700X
NM1190103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical