MEDICARE: AMY BOCK LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	C.1200545	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407294929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY BOCK LPCC

Provider Business Mailing Address
First Line	:	1385 KING AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43212-2220
Country	:	US
Telephone Number	:	716-866-0510
Fax Number	:

Provider Business Practice Location Address
First Line	:	1385 KING AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43212-2220
Country	:	US
Telephone Number	:	716-866-0510
Fax Number	:	614-437-7142

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2013
Last Update Date	:	11/15/2018

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Directions to “ AMY BOCK LPCC” Practice Location

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