Individual provider Active NPI

Amber Nicole Ransom, MA, LPC

  • Professional Counselor
  • Philadelphia, PA
National Provider Identifier
1063284255
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC015700 Issued in PA
Practice address
255 S 17TH St FL 9
Philadelphia, PA 19103-6209
Phone
(910) 916-3050
NPI assigned
Oct 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dance Therapist 225600000X R-DMT-2622 PA
Professional Counselor 101YP2500X PC015700 PA Primary

Addresses

Primary practice location

255 S 17TH St FL 9
Philadelphia, PA 19103-6209

Mailing address

5 Kern St
Collingdale, PA 19023-1902
Phone (910) 916-3050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240110002835 PA Practitioner - Mental Health Counselor 1355792755 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
R-DMT-2622PAMDDance Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Indlovu, LLC CurrentSince Jan 1, 2024 Accepting new patients
Dtap Mental Health Services LLC CurrentSince Dec 1, 2024 Accepting new patients

Locations

1120 W Township Line Rd
Ste 101
Havertown, PA 19083
Phone (267) 571-0383

Organizations & group practices 2

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": "1698019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1063284255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 KERN ST",
            "city": "COLLINGDALE",
            "state": "PA",
            "postal_code": "190231902",
            "telephone_number": "910-916-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 S 17TH ST FL 9",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036209",
            "telephone_number": "910-916-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANSOM",
        "first_name": "AMBER",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-23",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225600000X",
            "taxonomy_group": "",
            "desc": "Dance Therapist",
            "state": "PA",
            "license": "R-DMT-2622",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC015700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.