Provider Demographics
NPI:1518324144
Name:CLEMENS, AMBER (LMFT)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:CLEMENS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3620 W 10TH ST
Mailing Address - Street 2:STE B PMB 234
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634
Mailing Address - Country:US
Mailing Address - Phone:478-210-2251
Mailing Address - Fax:833-895-1171
Practice Address - Street 1:3620 W 10TH ST STE B
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-1852
Practice Address - Country:US
Practice Address - Phone:478-210-2251
Practice Address - Fax:833-895-1171
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-27
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203023106H00000X
PAMF000868261QM2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist