Individual provider Active NPI

Amia Hines, LPC

  • Mental Health Counselor
  • Media, PA
National Provider Identifier
1508606575
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PC017074 Issued in PA
Practice address
600 N Jackson St Ste 201
Media, PA 19063-2574
Phone
(610) 585-0307
NPI assigned
May 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 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 PC017074 PA Primary

Addresses

Primary practice location

600 N Jackson St Ste 201
Media, PA 19063-2574

Mailing address

518 Greenhill LN
Philadelphia, PA 19128-1061

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250102000618 PA Practitioner - Mental Health Counselor 9830639814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moore Psychological Services LLCGroup PAC ID 0648415646, 11 clinicians

Practice addresses (Care Compare)

600 N Jackson St
Suite 201
Media, PA 19063-2574
Phone (610) 585-0307

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Moore Psychological Services, LLC CurrentSince Jun 24, 2024 Accepting new patients

Locations

600 N Jackson St
Ste 201
Media, PA 19063
Phone (610) 585-0307

175 E Chester Pike
Ridley Park, PA 19078
Phone (610) 595-6000

Interoperability endpoints

  • Direct secure messaging: amia.hines.1@32853.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1716854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1508606575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 GREENHILL LN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191281061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N JACKSON ST STE 201",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190632574",
            "telephone_number": "610-585-0307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINES",
        "first_name": "AMIA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-28",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC017074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.