Individual provider Active NPI

Ameena Kemavor, LPCC-S

  • Mental Health Counselor
  • Blacklick, OH
National Provider Identifier
1457991952
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E.0500614 Issued in OH
Practice address
168 Bannockburn Blvd
Blacklick, OH 43004-9786
Phone
(614) 849-2389
NPI assigned
Jan 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E.0500614 OH
Mental Health Counselor 101YM0800X E.0500614 OH Primary

Addresses

Primary practice location

168 Bannockburn Blvd
Blacklick, OH 43004-9786

Mailing address

1900 Brice Rd Ste B
Reynoldsburg, OH 43068-3403
Phone (614) 239-9965

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
E.0500614OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Whitehall Cap Inc Mental Health PastSince Jan 1, 2020 Accepting new patients
Whitehall Cap Inc Mental Health PastSince Jan 1, 2020 Accepting new patients

Organizations & group practices 2

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": "1578873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1457991952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 BRICE RD STE B",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430683403",
            "telephone_number": "614-239-9965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 BANNOCKBURN BLVD",
            "city": "BLACKLICK",
            "state": "OH",
            "postal_code": "430049786",
            "telephone_number": "614-849-2389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMAVOR",
        "first_name": "AMEENA",
        "name_prefix": "Dr.",
        "credential": "LPCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-13",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.0500614",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.0500614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blacklick, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; 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.