Provider Demographics
NPI:1962756486
Name:KING, AMBER LYNN (LPC, MS)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:LYNN
Last Name:KING
Suffix:
Gender:F
Credentials:LPC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2609 COPPER KETTLE HWY
Mailing Address - Street 2:
Mailing Address - City:ROCKWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:15557-7205
Mailing Address - Country:US
Mailing Address - Phone:814-444-0620
Mailing Address - Fax:814-444-0640
Practice Address - Street 1:306 GEORGIAN PL
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-1611
Practice Address - Country:US
Practice Address - Phone:814-444-0620
Practice Address - Fax:814-444-0640
Is Sole Proprietor?:No
Enumeration Date:2012-11-06
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006992101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional