Provider Demographics
NPI:1174485833
Name:MENDOZA, AMBER LEIGH (LLPC)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:LEIGH
Last Name:MENDOZA
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:LEIGH
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:50688 RED IVY DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047-2615
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:50688 RED IVY DR
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-2615
Practice Address - Country:US
Practice Address - Phone:361-655-1217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-12-01
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451024763101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health