Active NPI
Adam Von Der Embse
- School Psychologist
- Canal Winchester, OH
National Provider Identifier
1336085968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 2030
- Practice address
- 100 Washington St
Canal Winchester, OH 43110-1224 - Phone
- (614) 920-2622
- NPI assigned
- Apr 27, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 2030 | OH | Primary |
Addresses
Primary practice location
100 Washington St
Canal Winchester, OH 43110-1224
Mailing address
100 Washington St
Canal Winchester, OH 43110-1224
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2030 | OH | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1777248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777248000000",
"number": "1336085968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 WASHINGTON ST",
"city": "CANAL WINCHESTER",
"state": "OH",
"postal_code": "431101224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 WASHINGTON ST",
"city": "CANAL WINCHESTER",
"state": "OH",
"postal_code": "431101224",
"telephone_number": "614-920-2622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VON DER EMBSE",
"first_name": "ADAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-04-27",
"last_updated": "2026-04-27",
"certification_date": "2026-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "OH",
"license": "2030",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canal Winchester, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.