Amy Michelle Childers, LPCC-S

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E.0600659-SUPV Issued in OH

Practice address

450 Cedar LN
Waterville, OH 43566-1107

Phone

(419) 283-2732

NPI assigned

Oct 13, 2008

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 6, 2023.

{
    "created_epoch": "1223856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691280000000",
    "number": "1649422452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CEDAR LN",
            "city": "WATERVILLE",
            "state": "OH",
            "postal_code": "435661107",
            "telephone_number": "419-283-2732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CEDAR LN",
            "city": "WATERVILLE",
            "state": "OH",
            "postal_code": "435661107",
            "telephone_number": "419-283-2732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDERS",
        "first_name": "AMY",
        "middle_name": "MICHELLE",
        "credential": "LPCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-13",
        "last_updated": "2023-08-06",
        "certification_date": "2023-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.0600659-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark R Bruss, M.D.
• Buckeye Forest at Waterville
• Jan Dale Castanza, RPH
• Barbara Jane Chaney, SLP
• Lynne Chapman I
• City of Waterville
• Zachary Clark, OTR/L
• Cornerstone Helping Hands of North West
• Rosemary L. D'Agostino, M.D.
• April R Davis, DMD

• All providers in Waterville, OH
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.

Verify at the official NPI Registry.