Individual provider Active NPI

Amy Lynn Fyffe, LCDCIII

  • Addiction (Substance Use Disorder) Counselor
  • Waverly, OH
National Provider Identifier
1639696651
Registry record updated Sep 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LCDCIII.161408 Issued in OH
Practice address
111 N High St
Waverly, OH 45690-1343
Phone
(740) 947-2364
Fax
(740) 947-2364
NPI assigned
Aug 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCDCIII.161408 OH Primary

Addresses

Primary practice location

111 N High St
Waverly, OH 45690-1343

Mailing address

107 N Bennett Ave
Jackson, OH 45640-1101
Phone (614) 857-5932

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
LCDCIII.161408OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pike County Recovery Council Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505174400000",
    "number": "1639696651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 N BENNETT AVE",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456401101",
            "telephone_number": "614-857-5932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N HIGH ST",
            "city": "WAVERLY",
            "state": "OH",
            "postal_code": "456901343",
            "telephone_number": "740-947-2364",
            "fax_number": "740-947-2364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FYFFE",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LCDCIII",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-30",
        "last_updated": "2017-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LCDCIII.161408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waverly, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2017; 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.