Amber Khyra Jamisen Nelson, LMHC, ATR, EMDR

Primary specialty

CounselorTaxonomy code 101Y00000X

License

MH15792 Issued in FL

Practice address

2123 Renaissance Blvd Apt 208
Miramar, FL 33025-5689

Phone

(850) 766-2628

NPI assigned

Mar 11, 2019

Last updated

Mar 11, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mariposita: Creative and Therapeutic Solutions

  • Adult Mental Health Clinic/Center
  • Crawfordville, FL
  • NPI 1720731219
  NPD

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1184182024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2123 RENAISSANCE BLVD APT 208",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330255689",
            "telephone_number": "850-766-2628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2123 RENAISSANCE BLVD APT 208",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330255689",
            "telephone_number": "850-766-2628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "AMBER",
        "middle_name": "KHYRA JAMISEN",
        "credential": "LMHC, ATR, EMDR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-11",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": "MH15792",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH15792",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ncare LLC
• Yania Negrin Cruz
• Kelly Negron
• Nelson Family Group
• Aretha Nelson-Casimir, MD
• Chantale Nelson
• Lucner Nelson
• Nest Medical Center PA
• Network Tpa, LLC
• Katherine E Neudahl, PHARM.D.

• Counselor in Miramar, FL
• Providers in Miramar, FL by specialty
• Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; 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.