Individual provider Active NPI

Amy Marie Krantz Metzgar, MA, LPC, NCC, NCSC

  • Professional Counselor
  • Cornelius, NC
National Provider Identifier
1073531430
Registry record updated Nov 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4138 Issued in NC
Practice address
8211 Village Harbor Dr
Cornelius, NC 28031-3706
Phone
(704) 881-3884
Fax
(704) 896-7836
NPI assigned
Jul 17, 2006
Last updated
Nov 13, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4138 NC Primary

Addresses

Primary practice location

8211 Village Harbor Dr
Cornelius, NC 28031-3706

Mailing address

PO Box 4734
Mooresville, NC 28117-4734
Phone (704) 881-3884

Other names 1

  • Ms. Amy Marie Fisherauer Former name

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
4138NCMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226534400000",
    "number": "1073531430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4734",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281174734",
            "telephone_number": "704-881-3884",
            "fax_number": "704-896-7836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8211 VILLAGE HARBOR DR",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280313706",
            "telephone_number": "704-881-3884",
            "fax_number": "704-896-7836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRANTZ METZGAR",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MA, LPC, NCC, NCSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2008-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "4138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "FISHERAUER",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cornelius, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2008; 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.