Provider Demographics
NPI:1578038451
Name:OVERSTREET, AMBER (LCPC)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:OVERSTREET
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1071
Mailing Address - Street 2:
Mailing Address - City:BIG TIMBER
Mailing Address - State:MT
Mailing Address - Zip Code:59011-1071
Mailing Address - Country:US
Mailing Address - Phone:406-930-1127
Mailing Address - Fax:
Practice Address - Street 1:209 MCLEOD ST
Practice Address - Street 2:
Practice Address - City:BIG TIMBER
Practice Address - State:MT
Practice Address - Zip Code:59011-7840
Practice Address - Country:US
Practice Address - Phone:406-930-1127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT32631101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health