Individual provider Active NPI

Amber Simmons

  • Mental Health Counselor
  • Atco, NJ
National Provider Identifier
1396130076
Registry record updated Mar 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
S4436 03763 58802 Issued in NJ
Practice address
2135 Tremont Ave
Atco, NJ 08004-1441
Phone
(215) 667-5216
NPI assigned
Mar 31, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X S4436 03763 58802 NJ Primary

Addresses

Primary practice location

2135 Tremont Ave
Atco, NJ 08004-1441

Mailing address

96 Tallwood LN
Willingboro, NJ 08046-4118
Phone (215) 667-5216

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

LicenseStateTypeSpecialty
S4436 03763 58802NJMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427760000000",
    "number": "1396130076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 TALLWOOD LN",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080464118",
            "telephone_number": "215-667-5216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2135 TREMONT AVE",
            "city": "ATCO",
            "state": "NJ",
            "postal_code": "080041441",
            "telephone_number": "215-667-5216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "AMBER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-31",
        "last_updated": "2015-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "S4436 03763 58802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atco, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; 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.