Provider Demographics
NPI:1578300208
Name:UNDERHILL, AMBER A (MED)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:A
Last Name:UNDERHILL
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:A
Other - Last Name:BELKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1305 CANTERBURY LN
Mailing Address - Street 2:
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-2711
Mailing Address - Country:US
Mailing Address - Phone:804-405-1110
Mailing Address - Fax:
Practice Address - Street 1:500 CONDUIT RD
Practice Address - Street 2:
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-3546
Practice Address - Country:US
Practice Address - Phone:804-524-3420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAPPS0607053101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool