Individual provider Active NPI

Amy Rynn, LCPC, ATR-BC, LPC

  • Professional Counselor
  • Marquette, MI
National Provider Identifier
1922680313
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401222979 Issued in MI
Practice address
1025 W Washington St Ste B
Marquette, MI 49855-4031
Phone
(906) 256-2951
Fax
(906) 629-6334
NPI assigned
Apr 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 180.011896 IL
Professional Counselor 101YP2500X 180.011896 IL
Professional Counselor 101YP2500X 6401222979 MI Primary

Addresses

Primary practice location

1025 W Washington St Ste B
Marquette, MI 49855-4031

Mailing address

1025 W Washington St Ste B
Marquette, MI 49855-4031
Phone (906) 256-2951

Other practice location 1

1108 W Washington St Ste C
Marquette, MI 49855-4076
Phone (906) 256-2951

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
180.011896ILMDProfessional Counselor
6401222979MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Woven Path Art Therapy and Counseling LLC Professional Current Accepting new patients
Caught Dreamin' Therapy, LLC CurrentSince Jun 1, 2022 Accepting new patients
Ewelina Beardmore Psychotherapy LLC PastSince May 1, 2021 Accepting new patients

Locations

1108 W Washington St
Ste C
Marquette, MI 49855
Phone (906) 256-2951

1025 W Washington St
Ste B
Marquette, MI 49855
Phone (906) 256-2951

Organizations & group practices 3

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": "1619308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1922680313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 W WASHINGTON ST STE B",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554031",
            "telephone_number": "906-256-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 W WASHINGTON ST STE B",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554031",
            "telephone_number": "906-256-2951",
            "fax_number": "906-629-6334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1108 W Washington St Ste C",
            "address_purpose": "LOCATION",
            "city": "Marquette",
            "state": "MI",
            "postal_code": "498554076",
            "country_code": "US",
            "telephone_number": "906-256-2951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYNN",
        "first_name": "AMY",
        "credential": "LCPC, ATR-BC, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-25",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "180.011896",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.011896",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401222979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; 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.