Individual provider Active NPI

Amelia Jenkins Walsh, L.M.F.T.

  • Marriage & Family Therapist
  • Fort Collins, CO
National Provider Identifier
1639476500
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
367 Issued in CO
Practice address
3938 John F Kennedy Pkwy Unit 11F
Fort Collins, CO 80525-3087
Phone
(949) 433-2319
NPI assigned
Feb 11, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 367 CO Primary
Marriage & Family Therapist 106H00000X 33271 CA

Addresses

Primary practice location

3938 John F Kennedy Pkwy Unit 11F
Fort Collins, CO 80525-3087

Mailing address

1377 Copeland Falls Rd
Severance, CO 80550-2872
Phone (949) 433-2319

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

LicenseStateTypeSpecialty
33271CAMDGeneral Practice Dentistry
367COMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1297382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1639476500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1377 COPELAND FALLS RD",
            "city": "SEVERANCE",
            "state": "CO",
            "postal_code": "805502872",
            "telephone_number": "949-433-2319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3938 JOHN F KENNEDY PKWY UNIT 11F",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253087",
            "telephone_number": "949-433-2319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "AMELIA",
        "middle_name": "JENKINS",
        "credential": "L.M.F.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-11",
        "last_updated": "2022-05-25",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CO",
            "license": "367",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "33271",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; 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.