Amy Rutherford, M. ED., LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

84390 Issued in TX

Practice address

3131 Executive Dr
San Angelo, TX 76904-6801

Phone

(325) 947-5021

Fax

(325) 267-2629

NPI assigned

Feb 22, 2023

Last updated

Jul 6, 2024By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1677024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720224000000",
    "number": "1538867122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 EXECUTIVE DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046801",
            "telephone_number": "325-947-5021",
            "fax_number": "325-267-2629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 EXECUTIVE DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046801",
            "telephone_number": "325-947-5021",
            "fax_number": "325-267-2629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTHERFORD",
        "first_name": "AMY",
        "credential": "M. ED., LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-22",
        "last_updated": "2024-07-06",
        "certification_date": "2024-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "84390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PROFESSIONAL COUNSELOR",
            "identifier": "84390",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "TherapyNotes",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3131 Executive Dr",
            "city": "San Angelo",
            "state": "TX",
            "country_code": "US",
            "postal_code": "769046801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Charles E Rudolph, PHD
• Ryan Rule, MD
• Ingrid Angela Russo, MSW, LCSW
• Harvey D Russwurm, MD
• Nicole Schmoll Russwurm, M.S. CCC-SLP
• Mallory Rochelle Ryalls
• Kellie Marie Ryan - Wilson, CNM
• Ryan L Montgomery DDS MD PLLC (Angelo Oral and Maxillofacial Surgery)
• Vernon L Ryan, MD
• S. Harding, DDS, P.a. (Affordable Dentures & Implants - San Angelo)

• Professional Counselor in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.