Provider Demographics
NPI:1215762422
Name:ELSWICK, AMBER (RMHCI, NCC)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:ELSWICK
Suffix:
Gender:F
Credentials:RMHCI, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 LAKE DAISY DR
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33884-2600
Mailing Address - Country:US
Mailing Address - Phone:786-376-4618
Mailing Address - Fax:
Practice Address - Street 1:444 LAKE DAISY DR
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33884-2600
Practice Address - Country:US
Practice Address - Phone:786-376-4618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH26478101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor