Individual provider Active NPI

Amy P Fibelkorn, CADC

  • Addiction (Substance Use Disorder) Counselor
  • Georgetown, DE
National Provider Identifier
1104070739
Registry record updated May 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
937 Issued in DE
Practice address
20728 N. Dupont Hwy, Ste. 313
Georgetown, DE 19947-0000
Phone
(302) 854-0172
NPI assigned
Nov 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 937 DE Primary

Addresses

Primary practice location

20728 N. Dupont Hwy, Ste. 313
Georgetown, DE 19947-0000

Mailing address

1241 College Park Dr
Dover, DE 19904-8713
Phone (302) 735-7790

Other identifiers 1

IdentifierTypeStateIssuer
1689733792MedicaidDE

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
937DEMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kent County Counseling Services Addiction (Substance Use Disorder) Past Accepting new patients
Kent County Counseling Services Addiction (Substance Use Disorder) Past Accepting new patients

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": "1226275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304294400000",
    "number": "1104070739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1241 COLLEGE PARK DR",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199048713",
            "telephone_number": "302-735-7790",
            "fax_number": "302-735-3654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20728 N. DUPONT HWY, STE. 313",
            "city": "GEORGETOWN",
            "state": "DE",
            "postal_code": "199470000",
            "telephone_number": "302-854-0172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIBELKORN",
        "first_name": "AMY",
        "middle_name": "P",
        "name_prefix": "Ms.",
        "credential": "CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-10",
        "last_updated": "2011-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "DE",
            "license": "937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689733792",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2011; 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.