Amy Marie Nelson Rivera, M.S., L.P.C.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC004629 Issued in GA

Practice address

85 Golf Crest Dr
Suite 309
Acworth, GA 30101-2698

Phone

(404) 918-0816

Fax

(404) 601-7495

NPI assigned

Sep 17, 2006

Last updated

Jan 29, 2015By 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

Other identifiers 1

Other names 1

• Amy Marie Nelson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422489600000",
    "number": "1467559013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 GOLF CREST DR",
            "address_2": "SUITE 309",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301012698",
            "telephone_number": "404-918-0816",
            "fax_number": "404-601-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 GOLF CREST DR",
            "address_2": "SUITE 309",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301012698",
            "telephone_number": "404-918-0816",
            "fax_number": "404-601-7495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "AMY",
        "middle_name": "MARIE NELSON",
        "name_prefix": "Mrs.",
        "credential": "M.S., L.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2015-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC004629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "095860337A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "NELSON",
            "middle_name": "MARIE",
            "credential": "M.S., L.P.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Richard J. Schleissinger D.P.M. P.C (Butler Creek Podiatry)
• Lauren Anne Richards, PT, DPT
• Nera E Richardson
• Righteous Hands Personal Care Agency, LLC
• Anna Riley
• Bryan Rivera, ATC, LAT
• Gordon Todd Robbins, M.D.
• Amanda Kristine Roberts, ATC
• May Amanukpo Robinson, MD
• Brenna Renee Roden, DC

• Professional Counselor in Acworth, GA
• Providers in Acworth, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.