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AMY MOULTON MA, LPC
NPI 1265067730
Counselor in Philadelphia, PA

Active since March 05, 2020Opted out of Medicare · through Feb 27, 2028
6060 RIDGE AVE STE 210, PHILADELPHIA, PA 19128(267) 627-4610 Get Directions Write a Review

NPPES record last updated: August 24, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 24, 2021, Oct 30, 2020, Mar 5, 2020 (3 updates tracked since 2020).

About Amy Moulton Ma, Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AMY MOULTON MA, LPC (NPI 1265067730) is an individual counselor in Philadelphia, Pennsylvania and active in the NPI registry since March 2020. She has opted out of Medicare through February 27, 2028.

NPPES Registry Identity

NPI1265067730
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameAMY MOULTONCredential: MA, LPC
Location Address6060 RIDGE AVE STE 210Philadelphia, PA 19128-1660
Mailing Address6060 Ridge Ave Ste 210Philadelphia, PA 19128-1660 · (267) 627-4610
Phone(267) 627-4610
Sole ProprietorYes
Enumeration DateMarch 5, 2020
Last NPPES UpdateAugust 24, 20213 updates tracked since enumeration
NPPES CertifiedAugust 24, 2021
✔ NPI 1265067730 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
6060 RIDGE AVE STE 210, Philadelphia, PA 19128
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Amy Moulton Ma, Lpc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 27, 2024 through February 27, 2028.

Opt-Out Effective DateFebruary 27, 2024
Opt-Out In Effect ThroughFebruary 27, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARY THERESA FITZGERALD LMFT
Marriage & Family Therapist
6060 RIDGE AVE STE 210
PHILADELPHIA, PA 19128
Philadelphia County (215) 290-2634

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Amy Moulton's NPI number?

The NPI number for Amy Moulton is 1265067730. It was assigned to this individual provider in the NPPES registry on March 5, 2020.

Where is Amy Moulton located?

Amy Moulton practices at 6060 Ridge Ave Ste 210, Philadelphia, PA 19128. The listed phone number is (267) 627-4610.

What is Amy Moulton's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Is Amy Moulton enrolled in Medicare?

No. Amy Moulton has opted out of Medicare through February 27, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Amy Moulton was last updated on August 24, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.