Provider Demographics
NPI:1649678335
Name:GREENELSH, AMBER JOY (LMFT83607)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:JOY
Last Name:GREENELSH
Suffix:
Gender:F
Credentials:LMFT83607
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5743 CORSA AVENUE
Mailing Address - Street 2:SUITE 221
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362
Mailing Address - Country:US
Mailing Address - Phone:805-657-0009
Mailing Address - Fax:
Practice Address - Street 1:5743 CORSA AVENUE
Practice Address - Street 2:SUITE 221
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362
Practice Address - Country:US
Practice Address - Phone:805-657-0009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-11
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT 83607106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist