Individual provider Active NPI

Amelia Gillis

  • Mental Health Counselor
  • Ocoee, FL
National Provider Identifier
1003275272
Registry record updated Feb 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH 14499 Issued in FL
Practice address
2704 Rew Cir Ste 105F
Ocoee, FL 34761-2994
Phone
(321) 436-8445
Fax
(407) 298-9166
NPI assigned
Feb 16, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMH 14499 FL Primary

Addresses

Primary practice location

2704 Rew Cir Ste 105F
Ocoee, FL 34761-2994

Mailing address

2704 Rew Cir Ste 105F
Ocoee, FL 34761-2994
Phone (321) 436-8445

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
IMH 14499FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ag Counseling & Consulting LLC Current Accepting new patients

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1455580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455580800000",
    "number": "1003275272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 REW CIR STE 105F",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347612994",
            "telephone_number": "321-436-8445",
            "fax_number": "407-298-9166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 REW CIR STE 105F",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347612994",
            "telephone_number": "321-436-8445",
            "fax_number": "407-298-9166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIS",
        "first_name": "AMELIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-16",
        "last_updated": "2016-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH 14499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocoee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.