Amber Avance I, M.S.,LPC-INTERN

Individual provider Active NPI Professional Counselor · Midlothian, TX

NPI 1760811756 · NPPES record last updated Nov 11, 2013

Key facts

NPI
1760811756
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
65294 (TX)
Practice address
408 W Avenue F
Midlothian, TX 76065-2963
Phone
(972) 723-0044
Fax
(972) 775-2002
NPI assigned
Nov 11, 2013
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
65294TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Freedom Counseling Assoicates, Inc. Professional Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 65294 TX Yes

Addresses

Primary practice location

408 W Avenue F
Midlothian, TX 76065-2963

Mailing address

408 W Avenue F
Midlothian, TX 76065-2963
Phone (972) 723-0044

Other identifiers

IdentifierTypeStateIssuer
65294OtherTXTEXAS STATE BOARD OF EXAMINERS OF PROFESSIONAL COUNSELORS

Other providers in Midlothian, TX

All providers in Midlothian, TX · Professional Counselor in Texas

Sources for this page

Verify at the official NPI Registry.