Individual provider Active NPI

Amy J Rudisill, MHS

  • Mental Health Counselor
  • Allentown, PA
National Provider Identifier
1376678409
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PC004900 Issued in PA
Practice address
1005 Brookside Rd Ste 80
Allentown, PA 18106-9023
Phone
(484) 867-7078
Fax
(833) 381-0909
NPI assigned
Feb 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X PC004900 PA Primary

Addresses

Primary practice location

1005 Brookside Rd Ste 80
Allentown, PA 18106-9023

Mailing address

1005 Brookside Rd Ste 80
Allentown, PA 18106-9023
Phone (484) 867-7078

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20260617001299 PA Practitioner - Mental Health Counselor 9234601642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2001
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1005 Brookside Rd
Suite 80
Allentown, PA 18106-9026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PC004900PAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Recover Psychotherapy & Counseling Servicesllc Current Accepting new patients

Locations

1005 Brookside Rd
Ste 80
Allentown, PA 18106
Phone (484) 867-7078

4403 Birkland Pl
Tatamy Borough, PA 18045
Phone (215) 469-1554

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1376678409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 BROOKSIDE RD STE 80",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181069023",
            "telephone_number": "484-867-7078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 BROOKSIDE RD STE 80",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181069023",
            "telephone_number": "484-867-7078",
            "fax_number": "833-381-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDISILL",
        "first_name": "AMY",
        "middle_name": "J",
        "credential": "MHS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC004900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.