Donald Amos

Individual provider Active NPI Mental Health Counselor · Springfield, OH

NPI 1669463469 · NPPES record last updated Sep 19, 2013

Key facts

NPI
1669463469
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
E0001681 (OH)
Practice address
474 N Yellow Springs St
Springfield, OH 45504-2463
Phone
(937) 399-9500
Fax
(937) 342-4236
NPI assigned
Oct 31, 2005
Sex
Male
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
E0001681OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Services for Clark Co Inc Current Accepting new patients

Locations

474 N Yellow Springs St
Springfield, OH 45504
Phone (937) 399-9500

2501 E High St
Springfield, OH 45505
Phone (937) 328-8700

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X E0001681 OH Yes

Addresses

Primary practice location

474 N Yellow Springs St
Springfield, OH 45504-2463

Mailing address

474 N Yellow Springs St
Springfield, OH 45504-2463
Phone (937) 399-9500

Other identifiers

IdentifierTypeStateIssuer
000000004369OtherOHANTHEM
0004577072OtherNDAETNA

Other providers in Springfield, OH

All providers in Springfield, OH · Mental Health Counselor in Ohio

Sources for this page

Verify at the official NPI Registry.