Amy Kemp Brockman

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC010385 Issued in GA

Practice address

310 Paper Trail Way Ste 106
Canton, GA 30115-5204

Phone

(678) 880-4645

Fax

(770) 628-0046

NPI assigned

Sep 25, 2018

Last updated

Sep 25, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Canton Counseling LLCGroup PAC ID 9830639749, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Canton Counseling, LLC

  • Professional Counselor
  • Canton, GA
  • NPI 1780014720
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537833600000",
    "number": "1710462874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 PAPER TRAIL WAY STE 106",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301155204",
            "telephone_number": "678-880-4645",
            "fax_number": "770-628-0046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 PAPER TRAIL WAY STE 106",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301155204",
            "telephone_number": "678-880-4645",
            "fax_number": "770-628-0046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKMAN",
        "first_name": "AMY",
        "middle_name": "KEMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-25",
        "last_updated": "2018-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC010385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridgemill Health Group LLC
• Bridging the Gap Therapy LLC
• Laurie Briegel, D.C.
• Louis Briegel II, D.C.
• Kallie Law Brock, D.M.D.
• Tressie Dawn Snipes Brooks, APRN
• Erin Brown-Lewis
• Amy Laura Brown, BCBA
• Gavin Fleming Brown, M.D.
• Hosanna Brown

• Mental Health Counselor in Canton, GA
• Providers in Canton, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.