Individual provider Active NPI

Amy Givens Moler, LPC

  • Mental Health Counselor
  • Dublin, VA
National Provider Identifier
1396766739
Registry record updated May 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0701003014 Issued in VA
Practice address
125 Broad Street
Dublin, VA 24084-3201
Phone
(540) 674-4506
Fax
(540) 674-4507
NPI assigned
Jul 21, 2006
Last updated
May 28, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2008

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 0701003014 VA Primary

Addresses

Primary practice location

125 Broad Street
Dublin, VA 24084-3201

Mailing address

PO Box 1183
Dublin, VA 24084-1183
Phone (540) 674-4506

Other identifiers 7

IdentifierTypeStateIssuer
178164OtherVALUE OPTIONS
276674-000OtherMOMAGELLAN
01-0006571MedicaidVA
237585OtherANTHEM
25180OtherVACARILION SERVICES, INC
1000010001010788352OtherPAUNITED HEALTHCARE INSURANCE COMPANY
18377OtherVAVIRGINIA PREMIER HEALTH PLAN

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
0701003014VAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Adult & Child - Family Counseling Inc Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211932800000",
    "number": "1396766739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1183",
            "city": "DUBLIN",
            "state": "VA",
            "postal_code": "240841183",
            "telephone_number": "540-674-4506",
            "fax_number": "540-674-4507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 BROAD STREET",
            "city": "DUBLIN",
            "state": "VA",
            "postal_code": "240843201",
            "telephone_number": "540-674-4506",
            "fax_number": "540-674-4507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLER",
        "first_name": "AMY",
        "middle_name": "GIVENS",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2008-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701003014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "178164",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "276674-000",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01-0006571",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "237585",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARILION SERVICES, INC",
            "identifier": "25180",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE INSURANCE COMPANY",
            "identifier": "1000010001010788352",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA PREMIER HEALTH PLAN",
            "identifier": "18377",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; 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.