Individual provider Active NPI

Amy Jenkins Nizza

  • Mental Health Counselor
  • Fayetteville, AR
National Provider Identifier
1487308177
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A2105012 Issued in AR
Practice address
3680 N Investment Dr Ste 1
Fayetteville, AR 72703-5458
Phone
(479) 435-9356
NPI assigned
Feb 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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 A2105012 AR Primary

Addresses

Primary practice location

3680 N Investment Dr Ste 1
Fayetteville, AR 72703-5458

Mailing address

2314 W Spruce St
Rogers, AR 72756-2153
Phone (479) 619-8313

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
A2105012ARMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1487308177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2314 W SPRUCE ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727562153",
            "telephone_number": "479-619-8313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3680 N INVESTMENT DR STE 1",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035458",
            "telephone_number": "479-435-9356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIZZA",
        "first_name": "AMY",
        "middle_name": "JENKINS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-10",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "A2105012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.