Individual provider Active NPI

Amy L Duplan

  • Professional Counselor
  • Long Beach, CA
National Provider Identifier
1194396986
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPCC16091 Issued in CA
Practice address
925 E 5TH St Apt 3
Long Beach, CA 90802-1677
Phone
(661) 972-5585
NPI assigned
Jul 2, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPCC16091 CA Primary

Addresses

Primary practice location

925 E 5TH St Apt 3
Long Beach, CA 90802-1677

Mailing address

925 E 5TH St Apt 3
Long Beach, CA 90802-1677
Phone (661) 972-5585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240523001460 CA Practitioner - Mental Health Counselor 2769824655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Serene HealthGroup PAC ID 0244652139, 23 clinicians

Practice addresses (Care Compare)

9265 Sky Park CT
Suite 100
San Diego, CA 92123-4375
Phone (619) 329-4483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPCC16091CAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Serene Health Ipa CurrentSince Mar 24, 2024 Accepting new patients
Serene Health Professional CurrentSince Mar 24, 2024 Accepting new patients

Locations

9265 Sky Park Ct
Ste 100
San Diego, CA 92123
Phone (619) 329-4483

4849 Ronson Ct
Ste 207
San Diego, CA 92111
Phone (619) 329-4483

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.

NPI Registry JSON

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

{
    "created_epoch": "1625184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1194396986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 E 5TH ST APT 3",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908021677",
            "telephone_number": "661-972-5585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 E 5TH ST APT 3",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908021677",
            "telephone_number": "661-972-5585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUPLAN",
        "first_name": "AMY",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-02",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "LPCC16091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.