Basic Information
Provider Information
NPI: 1134519028
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEHMAN MYERS
FirstName: AMBER
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: LEHMAN
OtherFirstName: AMBER
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 5045
Address2: ATTN: P.F.S. PROV ENRLLMT
City: SIOUX FALLS
State: SD
PostalCode: 571175045
CountryCode: US
TelephoneNumber: 6053226428
FaxNumber: 6053226499
Practice Location
Address1: 2412 S CLIFF AVE
Address2: STE 200
City: SIOUX FALLS
State: SD
PostalCode: 571054031
CountryCode: US
TelephoneNumber: 6053224079
FaxNumber: 6053224080
Other Information
ProviderEnumerationDate: 01/29/2015
LastUpdateDate: 01/29/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X3391SDY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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