Shiloh Amanda Wormley, LMHC

Individual provider Active NPI Mental Health Counselor · Phelps, NY

NPI 1316638513 · NPPES record last updated May 17, 2023

Key facts

NPI
1316638513
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
006441-01 (NY)
Practice address
1932 Fort Hill Rd
Phelps, NY 14532-9768
Phone
(315) 521-4505
NPI assigned
May 17, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
006441-01NYMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 006441-01 NY Yes

Addresses

Primary practice location

1932 Fort Hill Rd
Phelps, NY 14532-9768

Mailing address

1932 Fort Hill Rd
Phelps, NY 14532-9768
Phone (315) 521-4505

Other names

  • Shiloh Amanda Owens Former name

Other providers in Phelps, NY

All providers in Phelps, NY · Mental Health Counselor in New York

Sources for this page

Verify at the official NPI Registry.