Amber Self

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

167871 Issued in OH

Practice address

15221 St RT 124
Piketon, OH 45661

Phone

(740) 947-6727

NPI assigned

Dec 10, 2019

Last updated

Dec 10, 2019By the provider in NPPES

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1575936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1366089302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1957 WESTERN AVE APT 611",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456017513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15221 ST RT 124",
            "city": "PIKETON",
            "state": "OH",
            "postal_code": "45661",
            "telephone_number": "740-947-6727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELF",
        "first_name": "AMBER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-10",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "167871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taysha L Ross
• Jessica Scaggs-Stapleton
• Scioto Valley Local School District
• Paula Scott
• Sean Stiltner, D.O.,LLC
• Tracy Selvage, CDCA
• Kelly Sheets
• Kaela Danae Shirey, LPN
• Amber Silcott
• Gayle Rae Sinclair, RN

• Addiction (Substance Use Disorder) Counselor in Piketon, OH
• Providers in Piketon, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2019; 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.