Amy Jeanne Guderjohn

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

803 NE 17TH CT
Moore, OK 73160-6543

Phone

(405) 655-1295

NPI assigned

Nov 22, 2010

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

Medicare fee-for-service enrollment

Enrolled in OK

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

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 and National Provider Directory roles.

• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  OK

  Medicare reassignment NPD

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

{
    "created_epoch": "1290384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482105600000",
    "number": "1548562689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 NE 17TH CT",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731606543",
            "telephone_number": "405-655-1295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 NE 17TH CT",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731606543",
            "telephone_number": "405-655-1295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUDERJOHN",
        "first_name": "AMY",
        "middle_name": "JEANNE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-22",
        "last_updated": "2016-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clinton Don Griffin
• Allison Kay Griffiths
• Madilynn Grimes
• La Rea Ann Grimshaw, LPN
• Ashton Kaye Patricia Grose
• Jennifer Guerra, LPC
• Ashley Guinn
• Lisa Gunn
• Skylar Gracen Gurr
• Amber Lyn Guthrie, A.R.N.P.

• Mental Health Counselor in Moore, OK
• Providers in Moore, OK by specialty
• Mental Health Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2016; 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.