Provider Demographics
NPI:1689568107
Name:ROY, AMBER JASMINE
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:JASMINE
Last Name:ROY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E CENTER ST STE 301
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-4142
Mailing Address - Country:US
Mailing Address - Phone:740-541-4258
Mailing Address - Fax:
Practice Address - Street 1:333 E CENTER ST STE 301
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-4142
Practice Address - Country:US
Practice Address - Phone:740-541-4258
Practice Address - Fax:740-541-4258
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-09
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty