Provider Demographics
NPI:1598494700
Name:ISENHOWER, AMBER (ALC)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:ISENHOWER
Suffix:
Gender:F
Credentials:ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3102 DOVE RD SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-2812
Mailing Address - Country:US
Mailing Address - Phone:931-993-6764
Mailing Address - Fax:
Practice Address - Street 1:727 ARCADIA CIR NW STE E
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5907
Practice Address - Country:US
Practice Address - Phone:256-937-2525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC4138A101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional