Provider Demographics
NPI:1386322410
Name:DICKSON, AMBER JOY (LPC)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:JOY
Last Name:DICKSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6750 ANTIOCH RD STE 210
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66204-1260
Mailing Address - Country:US
Mailing Address - Phone:888-631-3938
Mailing Address - Fax:
Practice Address - Street 1:6750 ANTIOCH RD STE 210
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66204-1260
Practice Address - Country:US
Practice Address - Phone:888-631-3938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04395101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health