Individual provider Active NPI

Amy Constance Jean Cornwall, MA, LBS

  • Behavior Analyst
  • Lancaster, PA
National Provider Identifier
1043827702
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
BH005095 Issued in PA
Practice address
410 N Prince St
Lancaster, PA 17603-3010
Phone
(717) 560-7917
Fax
(717) 560-6452
NPI assigned
Sep 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X BH005095 PA Primary

Addresses

Primary practice location

410 N Prince St
Lancaster, PA 17603-3010

Mailing address

410 N Prince St
Lancaster, PA 17603-3010
Phone (717) 560-7917

Other names 1

  • Amy C Brown Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amy.cornwall@twponessa.com

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
BH005095PAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1043827702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 N PRINCE ST",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176033010",
            "telephone_number": "717-560-7917",
            "fax_number": "717-560-6452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N PRINCE ST",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176033010",
            "telephone_number": "717-560-7917",
            "fax_number": "717-560-6452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNWALL",
        "first_name": "AMY",
        "middle_name": "CONSTANCE JEAN",
        "credential": "MA, LBS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-28",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "PA",
            "license": "BH005095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amy.cornwall@twponessa.com",
            "affiliation": "N",
            "address_1": "410 N Prince St",
            "city": "Lancaster",
            "state": "PA",
            "country_code": "US",
            "postal_code": "176033010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "BROWN",
            "middle_name": "C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lancaster, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; 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.