AMY LOUISE MCDERMOTT LMHC, NPI 1497734867 — ST AUGUSTINE (FL)

NPI 1497734867

13+ Years Experience Individual

AMY LOUISE MCDERMOTT LMHC

01.12.2006
PROVIDER ENUMERATION DATE
07.08.2007
LAST UPDATE DATE
1497734867
NPI NUMBER

About AMY LOUISE MCDERMOTT

Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.

AMY LOUISE MCDERMOTT is a provider established in ST AUGUSTINE, FL. The NPI number of AMY LOUISE MCDERMOTT is 1497734867 and was assigned on 01.12.2006. The practitioners primary taxonomy code is: 101YM0800X with license number: MH 6706 FL .

Mailing address

  • City: ST AUGUSTINE
  • State: FL
  • Postal code: 320842600
  • Phone: 9048238787
  • Fax: 9048195330
  • Address: 2200 N PONCE DE LEON BLVD
  • Address 2: SUITE 3

Primary Practice Address

  • Region : ST AUGUSTINE, FL
  • NPI : 1497734867
  • Phone : 9048238787
  • Fax : 9048195330
  • Postalcode : 320842600
  • Address : 2200 N PONCE DE LEON BLVD SUITE 3

Provider taxonomy - Counselor

  • Taxonomy code: 101YM0800X
  • License number: MH 6706
  • License state: FL

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Contacts:

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  • AMY LOUISE MCDERMOTT LMHC
  • Address : 2200 N PONCE DE LEON BLVD SUITE 3
  • Region : ST AUGUSTINE, FL
  • NPI : 1497734867
  • Phone : 9048238787
  • Fax : 9048195330
  • Postalcode : 320842600

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address2200 N PONCE DE LEON BLVD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location AddressSUITE 3
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameST AUGUSTINE
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameFL
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code320842600
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number9048238787
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number9048195330
The fax number associated with the location address of the provider being identified.
NPI1497734867
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1101YM0800X
Provider Enumeration Date01.12.2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated07.08.2007
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)AMY LOUISE MCDERMOTT
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address2200 N PONCE DE LEON BLVD
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressSUITE 3
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameST AUGUSTINE
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameFL
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code320842600
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number9048238787
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number9048195330
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Healthcare Provider Taxonomy Code #1101YM0800X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Counselor
Provider License Number 1MH 6706
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1FL
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeF
  • M - male
  • F - female
Is sole proprietorN
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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