Provider Demographics
NPI:1396059762
Name:YOUNG, AMBER (MA, LMHC)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:BEVARS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:14074 TRADE CENTER DR
Mailing Address - Street 2:SUITE 116
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-4563
Mailing Address - Country:US
Mailing Address - Phone:317-914-7718
Mailing Address - Fax:844-374-3116
Practice Address - Street 1:14074 TRADE CENTER DR
Practice Address - Street 2:SUITE 116
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-4563
Practice Address - Country:US
Practice Address - Phone:317-914-7718
Practice Address - Fax:844-374-3116
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-28
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39002362A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health