Amy Anne Fordham, MA, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC2369 Issued in MN

Practice address

3800 Highway 52 N Ste 220
Rochester, MN 55901-5825

Phone

(507) 932-7321

Fax

(507) 540-1285

NPI assigned

Feb 3, 2020

Last updated

Apr 15, 2024By 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 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Brightside Medical PAGroup PAC ID 3678948809, 92 clinicians

Riverstone Psychological ServicesGroup PAC ID 0345479903, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Riverstone Psychological Services

  • Community/Behavioral Health Agency
  • Rochester, MN
  • NPI 1639590045
  Medicare reassignment Care Compare group NPD
• Brightside Medical, P.a.

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1609335660

  MN

  Medicare reassignment Care Compare group NPD
• Riverstone Assessment and Consulting Services, Inc.

  • Mental Health Counselor
  • Rochester, MN
  • NPI 1396576526
  NPD

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

{
    "created_epoch": "1580688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1316578867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 HIGHWAY 52 N STE 220",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559015825",
            "telephone_number": "507-932-7321",
            "fax_number": "507-540-1285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 HIGHWAY 52 N STE 220",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559015825",
            "telephone_number": "507-932-7321",
            "fax_number": "507-540-1285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORDHAM",
        "first_name": "AMY",
        "middle_name": "ANNE",
        "credential": "MA, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-03",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC2369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Rochester",
            "affiliation": "N",
            "address_1": "511 Northern Hills Dr NE Ste 2",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559064173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Maureen Forbrook, ATC
• Dennis J Forcelle, CRNA
• Mary A Forcelle, OT
• Kelsey Nicole Forcier, CRNA
• Gerard Forde, MB BCH BAO
• Megan Forestal, BCBA
• Christine Formea, PHARMD
• Roham Foroumadi, MD
• Danielle Sue Forrester, DNP, FNP-C
• Andrea Catherine Forslund, PHARMD

• Mental Health Counselor in Rochester, MN
• Providers in Rochester, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.