Amy Shantele Mills, LPC

Individual provider Active NPI Professional Counselor · Keene, TX

NPI 1164531331 · NPPES record last updated Mar 17, 2018

Key facts

NPI
1164531331
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
19670 (TX)
Practice address
207 S Val Verde Cir
Keene, TX 76059-1933
Phone
(682) 615-2080
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Generations Professional Counseling, PLLC Professional Past Accepting new patients
Catholic Charities of Fort Worth, Inc Professional Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 19670 TX Yes

Addresses

Primary practice location

207 S Val Verde Cir
Keene, TX 76059-1933

Mailing address

207 S Val Verde Cir
Keene, TX 76059-1933
Phone (682) 615-2080

Other practice location 1

2701 Burchill Rd N
Fort Worth, TX 76105-3012
Phone (817) 534-0814 ext. 3918

Other identifiers

IdentifierTypeStateIssuer
10035168OtherTXAMERIGROUP
175434301MedicaidTX

Other names

  • Miss Amy Shantele Beason Former name

Other providers in Keene, TX

All providers in Keene, TX · Professional Counselor in Texas

Sources for this page

Verify at the official NPI Registry.