Active NPI
Amelia Innis, MFT
- Marriage & Family Therapist
- West Chester, PA
National Provider Identifier
1124516604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 222 N Walnut St Ste E
West Chester, PA 19380-2608 - Phone
- (610) 348-7743
- NPI assigned
- Apr 30, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | PA | Primary |
Addresses
Primary practice location
222 N Walnut St Ste E
West Chester, PA 19380-2608
Mailing address
516 New Gulph Rd
Haverford, PA 19041-1617
Phone (610) 348-7743
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 10, 2024 through Jan 10, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593302400000",
"number": "1124516604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "516 NEW GULPH RD",
"city": "HAVERFORD",
"state": "PA",
"postal_code": "190411617",
"telephone_number": "610-348-7743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 N WALNUT ST STE E",
"city": "WEST CHESTER",
"state": "PA",
"postal_code": "193802608",
"telephone_number": "610-348-7743"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INNIS",
"first_name": "AMELIA",
"credential": "MFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-30",
"last_updated": "2020-06-28",
"certification_date": "2020-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "PA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Chester, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.