Provider Demographics
NPI:1023890381
Name:ROTHWELL, AMBER (CPRS)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:ROTHWELL
Suffix:
Gender:F
Credentials:CPRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44502-1039
Mailing Address - Country:US
Mailing Address - Phone:307-932-4873
Mailing Address - Fax:330-743-5748
Practice Address - Street 1:154 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HUBBARD
Practice Address - State:OH
Practice Address - Zip Code:44425-2155
Practice Address - Country:US
Practice Address - Phone:614-456-6050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-19
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPS.003219175T00000X
OHC.2405755-TRNE101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No175T00000XOther Service ProvidersPeer Specialist