Provider Demographics
NPI:1518584986
Name:FLEMING, AMBER BATES (MA, LPA)
Entity Type:Individual
Prefix:MS
First Name:AMBER
Middle Name:BATES
Last Name:FLEMING
Suffix:
Gender:F
Credentials:MA, LPA
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:NIKOLE
Other - Last Name:BATES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPA
Mailing Address - Street 1:210 HIGHCLERE LN
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:NC
Mailing Address - Zip Code:27576-8855
Mailing Address - Country:US
Mailing Address - Phone:984-989-7520
Mailing Address - Fax:
Practice Address - Street 1:8801 FAST PARK DR STE 101
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-4853
Practice Address - Country:US
Practice Address - Phone:704-703-8588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-01
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5727103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical