Amy Moulton, MA, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

6060 Ridge Ave Ste 210
Philadelphia, PA 19128-1660

Phone

(267) 627-4610

NPI assigned

Mar 5, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 27, 2024 through Feb 27, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Practice roles

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.

• Renew Family Services, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Elkins Park, PA
  • NPI 1922458108
  NPD (past)

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

{
    "created_epoch": "1583366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1265067730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6060 RIDGE AVE STE 210",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191281660",
            "telephone_number": "267-627-4610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6060 RIDGE AVE STE 210",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191281660",
            "telephone_number": "267-627-4610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULTON",
        "first_name": "AMY",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-05",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bohdan Motychak
• Nikolaos Mouchtouris, M.D.
• Beth Moughan, MD
• Lea Anne Moukarzel, M.D.
• Achintya Moulick, MD
• Alaa Mouminah
• Peter Mounas, DO
• Mount Airy Family Dental LLC
• Mount Airy Pain Management Center Inc.
• Mount Mecca Home Care LLC

• Counselor in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.