Micah Kymani Ambriz

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178.021565 Issued in IL

Practice address

7819 Galveston Blvd Apt D2
Norfolk, VA 23505-2722

Phone

(312) 919-7691

NPI assigned

Oct 1, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Micah Kymani Jordan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1759276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1063386191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7819 GALVESTON BLVD APT D2",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235052722",
            "telephone_number": "312-919-7691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7819 GALVESTON BLVD APT D2",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235052722",
            "telephone_number": "312-919-7691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBRIZ",
        "first_name": "MICAH",
        "middle_name": "KYMANI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-01",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.021565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICAH",
            "last_name": "JORDAN",
            "middle_name": "KYMANI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2025; 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.