Active NPI
Amy Pachelli
- Addiction (Substance Use Disorder) Counselor
- Vancouver, WA
National Provider Identifier
1114357076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CO60416435
- Practice address
- 1601 E 4TH Plain Blvd
BLDG 17 Ste B222
Vancouver, WA 98661-3753 - Phone
- (360) 397-8484
- Fax
- (360) 397-8494
- NPI assigned
- Nov 13, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CO60416435 | WA | Primary |
| Mental Health Counselor | 101YM0800X | CG60407511 | WA |
Addresses
Primary practice location
1601 E 4TH Plain Blvd
BLDG 17 Ste B222
Vancouver, WA 98661-3753
Mailing address
PO Box 1845
Vancouver, WA 98668-1845
Phone (360) 397-8484
Other names 1
- Ms. Amy Lou Fornasier
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
| License | State | Type | Specialty |
|---|---|---|---|
| CO60416435 | WA | MD | Addiction (Substance Use Disorder) Counselor |
| CG60407511 | WA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Services Northwest | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Vancouver, WA
- NPI 1720176894
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384300800000",
"number": "1114357076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1845",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986681845",
"telephone_number": "360-397-8484",
"fax_number": "360-397-8494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 E 4TH PLAIN BLVD",
"address_2": "BLDG 17 STE B222",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986613753",
"telephone_number": "360-397-8484",
"fax_number": "360-397-8494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACHELLI",
"first_name": "AMY",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-11-13",
"last_updated": "2013-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WA",
"license": "CO60416435",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "CG60407511",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMY",
"last_name": "FORNASIER",
"middle_name": "LOU",
"prefix": "MS.",
"credential": "CDPT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.