Active NPI
Amy E Nevells, LPC
- Professional Counselor
- Niskayuna, NY
National Provider Identifier
1619678000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 5760
- Practice address
- 866 Worcester Dr
Niskayuna, NY 12309-4923 - Phone
- (843) 812-4463
- NPI assigned
- Mar 13, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 5760 | SC | Primary |
Addresses
Primary practice location
866 Worcester Dr
Niskayuna, NY 12309-4923
Mailing address
866 Worcester Dr
Niskayuna, NY 12309-4923
Phone (843) 812-4463
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5760 | SC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678665600000",
"number": "1619678000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "866 WORCESTER DR",
"city": "NISKAYUNA",
"state": "NY",
"postal_code": "123094923",
"telephone_number": "843-812-4463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "866 WORCESTER DR",
"city": "NISKAYUNA",
"state": "NY",
"postal_code": "123094923",
"telephone_number": "843-812-4463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEVELLS",
"first_name": "AMY",
"middle_name": "E",
"name_prefix": "Ms.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-13",
"last_updated": "2023-03-13",
"certification_date": "2023-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "SC",
"license": "5760",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Niskayuna, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.