Individual provider Active NPI

Ammy Nienaber, LPCC

  • Mental Health Counselor
  • Centerville, OH
National Provider Identifier
1255878195
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C.1500867 Issued in OH
Practice address
77 W Elmwood Dr Ste 213
Centerville, OH 45459-4263
Phone
(937) 234-7830
Fax
(937) 723-8498
NPI assigned
Jan 30, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C.1500867 OH Primary

Addresses

Primary practice location

77 W Elmwood Dr Ste 213
Centerville, OH 45459-4263

Mailing address

77 W Elmwood Dr Ste 213
Centerville, OH 45459-4263
Phone (937) 234-7830

Other practice location 1

5600 Kentshire Dr Ste 101
Kettering, OH 45440-2963
Phone (937) 234-7830

Other practice location 2

5600 Kentshire Dr Ste 101
Kettering, OH 45440
Phone (937) 234-7830

Other identifiers 4

IdentifierTypeStateIssuer
H130910OtherOHMEDICARE GROUP PTAN
01-0693OtherOHCARF CERTIFICATION
0074861OtherOHMEDICAID-ODADAS
0074946OtherOHMEDICAID-ODMH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240328002199 OH Practitioner - Mental Health Counselor 9638516487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

77 W Elmwood Dr
Suite 213
Centerville, OH 45459-4263
Phone (937) 234-7830

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.1500867OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Another Chance Therapy Services LLC CurrentSince Aug 1, 2023 Accepting new patients
Wink of Hope Counseling, LLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Access Counseling Services, LLC Past Accepting new patients
Access Counseling Services LLC Mental Health PastSince Nov 4, 2014 Accepting new patients

Locations

77 W Elmwood Dr
Ste 213
Dayton, OH 45459
Phone (937) 234-7830

5600 Kentshire Dr
Ste 101
Dayton, OH 45440
Phone (937) 234-7830

Organizations & group practices 4

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": "1485734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1255878195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 W ELMWOOD DR STE 213",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454594263",
            "telephone_number": "937-234-7830",
            "fax_number": "937-723-8498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W ELMWOOD DR STE 213",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454594263",
            "telephone_number": "937-234-7830",
            "fax_number": "937-723-8498"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5600 Kentshire Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454402963",
            "country_code": "US",
            "telephone_number": "937-234-7830",
            "fax_number": "937-999-4216",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5600 Kentshire Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "45440",
            "country_code": "US",
            "telephone_number": "937-234-7830",
            "fax_number": "937-999-4216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIENABER",
        "first_name": "AMMY",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-30",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.1500867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "H130910",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARF CERTIFICATION",
            "identifier": "01-0693",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID-ODADAS",
            "identifier": "0074861",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID-ODMH",
            "identifier": "0074946",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerville, OH

Sources for this page

Verify at the official NPI Registry.