Amber Nicole Henry, PEER SUPPORTER

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

SS521668 Issued in OH

Practice address

1195 Sullivant Ave
Columbus, OH 43223-1350

Phone

(614) 975-5849

NPI assigned

Jan 19, 2022

Last updated

Jan 19, 2022By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1184376485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S HAGUE AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432042405",
            "telephone_number": "614-975-5849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1195 SULLIVANT AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432231350",
            "telephone_number": "614-975-5849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "AMBER",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PEER SUPPORTER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OH",
            "license": "SS521668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102150043-00",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Henriques, DPT
• Rena Michelle Henriques, M.D.
• Jamir Henriquez
• Melissa Anne Henry Sweet, CNP
• Regina Henry-Morris
• Charles Wesley Henry
• Cheryl Henry
• Damaris Henry
• Dezerae Henry
• Elizabeth Henry, MS

• Peer Specialist in Columbus, OH
• Providers in Columbus, OH by specialty
• Peer Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; 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.