Provider Demographics
NPI:1578049862
Name:EDWARDS, AMBER RENEE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:RENEE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:AMBER
Other - Middle Name:RENEE
Other - Last Name:MOORE-EDWARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC INTERN
Mailing Address - Street 1:16718 HOUSE HAHL ROAD
Mailing Address - Street 2:SUITE D
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433
Mailing Address - Country:US
Mailing Address - Phone:832-549-1356
Mailing Address - Fax:
Practice Address - Street 1:16718 HOUSE HAHL ROAD
Practice Address - Street 2:SUITE D
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433
Practice Address - Country:US
Practice Address - Phone:832-549-1356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74388101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional