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AMY KEMP BROCKMAN
NPI 1710462874
Counselor - Mental Health in Canton, GA

Active since September 25, 2018PECOS EnrolledAccepts Medicare Assignment
310 PAPER TRAIL WAY STE 106, CANTON, GA 30115(678) 880-4645(770) 628-0046 Get Directions Write a Review

NPPES record last updated: September 25, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Amy Kemp Brockman NPPES

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

AMY KEMP BROCKMAN (NPI 1710462874) is an individual mental health provider in Canton, Georgia, licensed in Georgia (LPC010385) and active in the NPI registry since September 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1710462874
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameAMY KEMP BROCKMAN
Location Address310 PAPER TRAIL WAY STE 106Canton, GA 30115-5204
Mailing Address310 Paper Trail Way Ste 106Canton, GA 30115-5204 · (678) 880-4645 · Fax (770) 628-0046
Phone(678) 880-4645
Fax(770) 628-0046
Sole ProprietorYes
Medical School CMSOtherGraduated 2014
Enumeration DateSeptember 25, 2018
✔ NPI 1710462874 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in GA · LPC010385
310 PAPER TRAIL WAY STE 106, Canton, GA 30115
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Amy Kemp Brockman is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5698215234
PECOS Enrollment IDI20240910000674
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 10

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

JOY TULLOCH
Counselor (Mental Health)
310 PAPER TRAIL WAY STE 106
CANTON, GA 30115
Cherokee County (678) 880-4645
JOY ADA CRONAUER LAPC
Counselor (Mental Health)
310 PAPER TRAIL WAY STE 106
CANTON, GA 30115
Cherokee County (770) 557-6577
DEREK STRUCHTEMEYER LPC
Counselor (Professional)
310 PAPER TRAIL WAY STE 106
CANTON, GA 30115
Cherokee County (678) 880-4645
ROBIN JOINER
Counselor (Professional)
310 PAPER TRAIL WAY STE 106
CANTON, GA 30115
Cherokee County (678) 880-4645
MARTHA HUEY TAYLOR MS, NCC
Counselor (Mental Health)
310 PAPER TRAIL WAY STE 106
CANTON, GA 30115
Cherokee County (678) 880-4645
TAELAR BYBEE
Counselor (Mental Health)
310 PAPER TRAIL WAY STE 106
CANTON, GA 30115
Cherokee County (678) 880-4645
HOLLY MEGAN BARKER
Counselor (Mental Health)
310 PAPER TRAIL WAY STE 106
HOLLY SPRINGS, GA 30115
Cherokee County (470) 485-7115
JON PATRICK COSTALES LPC
Counselor (Professional)
310 PAPER TRAIL WAY STE 106
CANTON, GA 30115
Cherokee County (678) 880-4645

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 Brockman's NPI number?

The NPI number for Amy Brockman is 1710462874. It was assigned to this individual provider in the NPPES registry on September 25, 2018.

Where is Amy Brockman located?

Amy Brockman practices at 310 Paper Trail Way Ste 106, Canton, GA 30115. The listed phone number is (678) 880-4645.

What is Amy Brockman's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Amy Brockman enrolled in Medicare?

Yes. Amy Brockman is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Amy Brockman was last updated on September 25, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.