Provider Demographics
NPI:1508533423
Name:LYNN, AMBER K (LCMHC)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:K
Last Name:LYNN
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:K
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCMHCA
Mailing Address - Street 1:111 WILDIRIS DR
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-3709
Mailing Address - Country:US
Mailing Address - Phone:440-522-8174
Mailing Address - Fax:
Practice Address - Street 1:10224 HICKORYWOOD HILL AVE STE 205
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-3474
Practice Address - Country:US
Practice Address - Phone:704-896-9405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-27
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA16889101YM0800X
NC16889101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health