Individual provider Active NPI

Amy Jo Driskill, M.S., LCMFT

  • Marriage & Family Therapist
  • Wichita, KS
National Provider Identifier
1487846564
Registry record updated Jan 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LCMFT 735 Issued in KS
Practice address
4425 W Zoo Blvd
Suite 3
Wichita, KS 67212-1620
Phone
(316) 749-2007
Fax
(316) 749-2008
NPI assigned
Aug 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 735 KS
Marriage & Family Therapist 106H00000X LCMFT 735 KS Primary

Addresses

Primary practice location

4425 W Zoo Blvd
Suite 3
Wichita, KS 67212-1620

Mailing address

145 S Breezy Pointe CT
Wichita, KS 67235-1415
Phone (316) 749-2007

Other identifiers 1

IdentifierTypeStateIssuer
200443380EMedicaidKS

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
735KSMDAddiction (Substance Use Disorder) Counselor
LCMFT 735KSMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Counseling Center LLC Past Accepting new patients
Julie Miller Corp Past 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": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516320000000",
    "number": "1487846564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 S BREEZY POINTE CT",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672351415",
            "telephone_number": "316-749-2007",
            "fax_number": "316-943-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 W ZOO BLVD",
            "address_2": "SUITE 3",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672121620",
            "telephone_number": "316-749-2007",
            "fax_number": "316-749-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRISKILL",
        "first_name": "AMY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "M.S., LCMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-13",
        "last_updated": "2018-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KS",
            "license": "735",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KS",
            "license": "LCMFT 735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200443380E",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2018; 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.