Amy Fowler Jaynes, MS, LPC, NCC, CRC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

8499 Issued in GA

Practice address

130 Governors SQ Ste B
Peachtree City, GA 30269-4862

Phone

(770) 451-0404

NPI assigned

Aug 27, 2013

Last updated

Jan 27, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Center for Living Balance, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Peachtree City, GA
  • NPI 1457876906
  NPD Authorized official

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1538593579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 GOVERNORS SQ STE B",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302694862",
            "telephone_number": "770-451-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 GOVERNORS SQ STE B",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302694862",
            "telephone_number": "770-451-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAYNES",
        "first_name": "AMY",
        "middle_name": "FOWLER",
        "credential": "MS, LPC, NCC, CRC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-27",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "8499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Peachtree City, GA
• Providers in Peachtree City, 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 27, 2020; 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.