Provider Demographics
NPI:1346625902
Name:PENN, AMBER JUNE (PSYD)
Entity type:Individual
Prefix:DR
First Name:AMBER
Middle Name:JUNE
Last Name:PENN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:AMBER
Other - Middle Name:JUNE
Other - Last Name:GORZYNSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:PO BOX 43261
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40253-0261
Mailing Address - Country:US
Mailing Address - Phone:502-625-5571
Mailing Address - Fax:502-688-5257
Practice Address - Street 1:PO BOX 43261
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40253-0261
Practice Address - Country:US
Practice Address - Phone:502-625-5571
Practice Address - Fax:502-688-5257
Is Sole Proprietor?:No
Enumeration Date:2015-07-24
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY263092103TC0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical