Active NPI
Amanda Marie Painter, LCSW
- Clinical Social Worker
- Wellsville, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 8934266-3501
- Practice address
- 2180 S 1450 W
Wellsville, UT 84339-6733 - Phone
- (801) 695-5520
- NPI assigned
- Aug 29, 2012
- Last updated
- Nov 8, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 8934266-3501 | UT | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 8934266-3501 | UT | |
| Mental Health Counselor | 101YM0800X | 8934266-3501 | UT | |
| Social Worker | 104100000X | 8934266-3501 | UT | |
| Case Manager/Care Coordinator | 171M00000X | 8934266-3501 | UT | |
| Adult Companion | 372600000X | |||
| Clinical Social Worker | 1041C0700X | 8934266-3501 | UT | Primary |
Addresses
Primary practice location
2180 S 1450 W
Wellsville, UT 84339-6733
Mailing address
2180 S 1450 W
Wellsville, UT 84339-6733
Phone (801) 695-5520
Other names 1
- Amanda Marie Takacs
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
12127B N Hwy 14
Suite 5
Cedar Crest, NM 87008-9557
Phone (505) 281-5180
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8934266-3501 | UT | MD | Case Manager/Care Coordinator |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McLeod Medical Centers of NM, Inc. | Current | Accepting new patients | |
| McLeod Medical Centers of NM, Inc. | Current | Accepting new patients |
Locations
7200 Montgomery Blvd NE
Ste 7121
Albuquerque, NM 87109
Phone (408) 781-0505
12127 N State Highway 14
Ste 5
Cedar Crest, NM 87008
Phone (505) 281-2460
Interoperability endpoints
- amanda.painter.1@27050.direct.athenahealth.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Duke City Primary Care
- Family Medicine Physician
- Cedar Crest, NM
- NPI 1700393782
-
dba Duke City Primary Care
- Family Medicine Physician
- Cedar Crest, NM
- NPI 1215580832
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731024000000",
"number": "1013265644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2180 S 1450 W",
"city": "WELLSVILLE",
"state": "UT",
"postal_code": "843396733",
"telephone_number": "801-695-5520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2180 S 1450 W",
"city": "WELLSVILLE",
"state": "UT",
"postal_code": "843396733",
"telephone_number": "801-695-5520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAINTER",
"first_name": "AMANDA",
"middle_name": "MARIE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-29",
"last_updated": "2024-11-08",
"certification_date": "2024-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "UT",
"license": "8934266-3501",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "UT",
"license": "8934266-3501",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "UT",
"license": "8934266-3501",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "UT",
"license": "8934266-3501",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "UT",
"license": "8934266-3501",
"primary": false
},
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "8934266-3501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMANDA",
"last_name": "TAKACS",
"middle_name": "MARIE",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Wellsville, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.