Diane Nicole Kennedy-Amos, LPC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

0701004708 Issued in VA

Practice address

410 Thomas Jefferson Highway
Charlotte Court House, VA 23923-0340

Phone

(434) 392-7049

Fax

(434) 392-9221

NPI assigned

May 6, 2010

Reactivated

Mar 4, 2011

Last updated

Mar 4, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Crossroads Services Board

  • Community/Behavioral Health Agency
  • Farmville, VA
  • NPI 1528091063
  NPD (past)

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

{
    "created_epoch": "1273104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299196800000",
    "number": "1275851891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 THOMAS JEFFERSON HIGHWAY",
            "city": "CHARLOTTE COURT HOUSE",
            "state": "VA",
            "postal_code": "239230340",
            "telephone_number": "434-392-7049",
            "fax_number": "434-392-9221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 THOMAS JEFFERSON HIGHWAY",
            "city": "CHARLOTTE COURT HOUSE",
            "state": "VA",
            "postal_code": "239230340",
            "telephone_number": "434-392-7049",
            "fax_number": "434-392-9221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY-AMOS",
        "first_name": "DIANE",
        "middle_name": "NICOLE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-06",
        "last_updated": "2011-03-04",
        "deactivation_date": "2010-05-11",
        "reactivation_date": "2011-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "VA",
            "license": "0701004708",
            "primary": true
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "VA",
            "license": "0812000549",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah I Johnson
• Courtney Bailey Jones, AGACNP-BC
• Jennifer Gallagher Jones, NP-C
• Shawna Jones
• Kimberly Dawn Jubb, FNP
• Kimberly Anne Leftwich, RN, MSN-FNP
• Jennifer Lloyd, PHARMD
• Elizabeth Faye Loftis, BCBA, LBA
• Love Over Crisis LLC
• Shelley Mays-Couch, LCSW

• Counseling Psychologist in Charlotte Court House, VA
• Providers in Charlotte Court House, VA by specialty
• Counseling Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2011; 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.