Active NPI
Amy Antonioli, BCBA, LBS
- Professional Counselor
- Fleetwood, PA
National Provider Identifier
1639617434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- BH005613
- Practice address
- 1 W Main St
Fleetwood, PA 19522-1350 - Phone
- (814) 596-2931
- NPI assigned
- Feb 1, 2017
- Sex
- Female
- Sole proprietor
- No
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 | BH005613 | PA | Primary |
Addresses
Primary practice location
1 W Main St
Fleetwood, PA 19522-1350
Mailing address
One West Main St.
Fleetwood, PA 19522-1356
Phone (814) 596-2931
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 |
|---|---|---|---|
| BH005613 | PA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636329600000",
"number": "1639617434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "ONE WEST MAIN ST.",
"city": "FLEETWOOD",
"state": "PA",
"postal_code": "195221356",
"telephone_number": "814-596-2931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 W MAIN ST",
"city": "FLEETWOOD",
"state": "PA",
"postal_code": "195221350",
"telephone_number": "814-596-2931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTONIOLI",
"first_name": "AMY",
"credential": "BCBA, LBS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-01",
"last_updated": "2021-11-08",
"certification_date": "2021-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "PA",
"license": "BH005613",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fleetwood, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.