Provider Demographics
NPI:1588162564
Name:CLEVERLY-THOMAS, AMBER MARIE (MSW, MHP, CMHS, AGEN)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:MARIE
Last Name:CLEVERLY-THOMAS
Suffix:
Gender:F
Credentials:MSW, MHP, CMHS, AGEN
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:MARIE
Other - Last Name:CLEVERLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1321 W BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201
Mailing Address - Country:US
Mailing Address - Phone:509-473-4810
Mailing Address - Fax:509-473-4840
Practice Address - Street 1:1321 W BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201
Practice Address - Country:US
Practice Address - Phone:509-473-4810
Practice Address - Fax:509-473-4840
Is Sole Proprietor?:No
Enumeration Date:2018-01-25
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor