Amy Lyn Kesslick, MA,MT-BC,LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC010998 Issued in PA

Practice address

850 N 11TH St
Philadelphia, PA 19123-1957

Phone

(215) 769-1114

NPI assigned

Jan 10, 2019

Last updated

Jun 17, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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 PA

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Main Line Therapy Solutions LLCGroup PAC ID 2860782794, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Main Line Therapy Solutions, LLC

  • Mental Health Counselor
  • Haverford, PA
  • NPI 1386932366
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1891268025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 N 11TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191231957",
            "telephone_number": "215-769-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 N 11TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191231957",
            "telephone_number": "215-769-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESSLICK",
        "first_name": "AMY",
        "middle_name": "LYN",
        "name_prefix": "Mrs.",
        "credential": "MA,MT-BC,LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-10",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC010998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Elaine Sullivan Kessler, OTR/L
• Rene Phillips Kessler
• Riley Kessler, MD
• Robert Neil Kessler, D.C.
• Sudha Kilaru Kessler, MD
• Rebecca Kesslick, ATC
• Ketan B Patel DMD PC
• Claire E Ketchem, MD
• Margaux Hart Ketner, MA
• Keyona Ketter

• Professional Counselor in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; 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.