Provider Demographics
NPI:1053444240
Name:NIMS, AMELIA KATHERINE PFEIFFER (MA, PCC-S)
Entity Type:Individual
Prefix:MS
First Name:AMELIA
Middle Name:KATHERINE PFEIFFER
Last Name:NIMS
Suffix:
Gender:F
Credentials:MA, PCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5049 REED RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-2513
Mailing Address - Country:US
Mailing Address - Phone:614-563-4264
Mailing Address - Fax:
Practice Address - Street 1:918 S FRONT ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43206-2521
Practice Address - Country:US
Practice Address - Phone:614-563-4264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC0501087101YP2500X
OHE0501087101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional