Coram Consulting LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2862-57 Issued in WI

Legal business name

CORAM CONSULTING LLC

Practice address

431 S Main St Ste 6
Rice Lake, WI 54868-2241

Phone

(715) 931-0317

NPI assigned

Feb 2, 2017

Last updated

Jul 26, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Amber G Ebert, PSYDNPI 1033433396

Title

Licensed Psychologist

Phone

(715) 931-0317

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amber Gerber Ebert

  • Clinical Psychologist
  • Cameron, WI
  • NPI 1033433396
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690329600000",
    "number": "1427596121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 N 2ND ST STE C",
            "city": "CAMERON",
            "state": "WI",
            "postal_code": "548227736",
            "telephone_number": "715-931-0317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 S MAIN ST STE 6",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548682241",
            "telephone_number": "715-931-0317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORAM CONSULTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-02",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A",
        "authorized_official_last_name": "EBERT",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "715-931-0317",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "2862-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clear Path Clinic SC
• Zachary Alan Cole, DC
• Renee M Coleman
• Chad Michael Collins, LCSW
• Kimberly Leah Collymore, FNP
• Michelle R Corbin, OTR
• Cornerstone Caregiving East LLC
• Megan R Coss
• Amy L Crabtree, MS CCC SLP
• John A Cragg, MD

• Clinical Psychologist in Rice Lake, WI
• Providers in Rice Lake, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.