Active NPI
Amy Jane Devore, LPC
- Professional Counselor
- Valley Park, MO
National Provider Identifier
1215540844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 200603292012
- Practice address
- 217 Bracadale Ave
Valley Park, MO 63088-1536 - Phone
- (314) 482-3339
- NPI assigned
- Aug 24, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 200603292012 | MO | Primary |
Addresses
Primary practice location
217 Bracadale Ave
Valley Park, MO 63088-1536
Mailing address
217 Bracadale Ave
Valley Park, MO 63088-1536
Phone (314) 482-3339
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200603292012 | MO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Doctor on Demand Professionals P C | Current | Accepting new patients |
Locations
1 California St
Ste 2300
San Francisco, CA 94111
Phone (800) 929-0926
221 Bolivar St
Jefferson Cty, MO 65101
Phone 56129936671572
Organizations & group practices 1
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": "1598227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598227200000",
"number": "1215540844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "217 BRACADALE AVE",
"city": "VALLEY PARK",
"state": "MO",
"postal_code": "630881536",
"telephone_number": "314-482-3339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "217 BRACADALE AVE",
"city": "VALLEY PARK",
"state": "MO",
"postal_code": "630881536",
"telephone_number": "314-482-3339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVORE",
"first_name": "AMY",
"middle_name": "JANE",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-24",
"last_updated": "2020-08-24",
"certification_date": "2020-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "200603292012",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Valley Park, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.