Provider Demographics
NPI:1568072320
Name:PRZYBYLA, AMBER (LPC-I)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:PRZYBYLA
Suffix:
Gender:F
Credentials:LPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6415 TRANQUILO APT 3004
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-3195
Mailing Address - Country:US
Mailing Address - Phone:312-344-0241
Mailing Address - Fax:
Practice Address - Street 1:2130 GREEN BAY RD
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3026
Practice Address - Country:US
Practice Address - Phone:847-425-9708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83805101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health