Provider Demographics
NPI:1629468228
Name:STEVENS, AMBER (PSYD)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:
Last Name:STEVENS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2245 GILBERT AVE STE 303
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-3000
Mailing Address - Country:US
Mailing Address - Phone:513-519-0409
Mailing Address - Fax:
Practice Address - Street 1:2245 GILBERT AVE STE 303
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-3000
Practice Address - Country:US
Practice Address - Phone:513-216-0068
Practice Address - Fax:513-216-0068
Is Sole Proprietor?:No
Enumeration Date:2015-02-03
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071009033103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical