Provider Demographics
NPI:1760811756
Name:AVANCE, AMBER I (MS,LPC-INTERN)
Entity Type:Individual
Prefix:MS
First Name:AMBER
Middle Name:
Last Name:AVANCE
Suffix:I
Gender:F
Credentials:MS,LPC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 W AVENUE F
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-2963
Mailing Address - Country:US
Mailing Address - Phone:972-723-0044
Mailing Address - Fax:972-775-2002
Practice Address - Street 1:408 W AVENUE F
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-2963
Practice Address - Country:US
Practice Address - Phone:972-723-0044
Practice Address - Fax:972-775-2002
Is Sole Proprietor?:No
Enumeration Date:2013-11-11
Last Update Date:2013-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65294101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX65294OtherTEXAS STATE BOARD OF EXAMINERS OF PROFESSIONAL COUNSELORS