Individual
AMBER BLACKWOOD MINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED, LCMHC, LPC
Contact information
Practice address
1300C GIDNEY ST, SHELBY, NC 28150-6822
(704) 484-2558
Mailing address
114 ROBERTS AVE, YORK, SC 29745-1303
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
11198
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11198
NORTH CAROLINA BOARD OF LICENSED CLINICAL MENTAL HEALTH COUNSELORS
NC
01
—
9199
SOUTH CAROLINA BOARD OF LICENSED PROFESSIONAL COUNSELORS
SC
Enumeration date
11/03/2014
Last updated
11/08/2023
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