Basic Information
| Provider Information | |||||||||
| NPI: | 1952830291 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HELLEBUYCK | ||||||||
| FirstName: | AMBER | ||||||||
| MiddleName: | NICHOLE | ||||||||
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| Credential: | LLBSW, BSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21103 CHARTER OAKS DR | ||||||||
| Address2: | |||||||||
| City: | DAVISON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 484232523 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8102786065 | ||||||||
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| Practice Location | |||||||||
| Address1: | 420 W 5TH AVE | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485032445 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8102573705 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2017 | ||||||||
| LastUpdateDate: | 06/09/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | 1043554348 | MI | Y | Agencies | Community/Behavioral Health |
No ID Information.