Amy O'Dell, M.ED, LPC, TRS, CNC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC004163 Issued in GA

Practice address

407 Hardscrabble Rd
Roswell, GA 30075-1417

Phone

(770) 998-1017

Fax

(770) 998-3258

NPI assigned

Jun 2, 2011

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

Other names 1

• Amy O'Dell-Wuttke Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

Practice roles

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.

• Jacob'S Ladder Neurodevelopmental Learning Center

  • Professional Counselor
  • Roswell, GA
  • NPI 1871818641
  NPD (past) Authorized official
• Jacob'S Ladder

  • Community/Behavioral Health Agency
  • Roswell, GA
  • NPI 1447637343
  NPD (past)

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

{
    "created_epoch": "1306972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306972800000",
    "number": "1962796433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 HARDSCRABBLE RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300751417",
            "telephone_number": "770-998-1017",
            "fax_number": "770-998-3258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 HARDSCRABBLE RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300751417",
            "telephone_number": "770-998-1017",
            "fax_number": "770-998-3258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DELL",
        "first_name": "AMY",
        "credential": "M.ED, LPC, TRS, CNC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-02",
        "last_updated": "2011-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC004163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "O'DELL-WUTTKE",
            "credential": "M.ED, LPC, TRS, CNC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chinwe Nwizugbo
• Ronjonette Nacole O'Bannon, LCSW
• Valorie O'Brien
• Nicole O'Connor, NP
• Connor Jared O'Daniels, PHARMD
• Daniella O'Garro, LAPC
• Adrian Cheria O'Neal, D.M.D.
• Gwendolyn Patricia O'Neal
• Kelli J O'Neil, MS, RD, LD, CDE
• Oasis Health Services LLC

• Professional Counselor in Roswell, GA
• Providers in Roswell, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2011; 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.