Amanda Marie Painter, LCSW
Individual provider Active NPI Clinical Social Worker · Wellsville, UT
NPI 1013265644 · NPPES record last updated Nov 8, 2024
Key facts
- NPI
- 1013265644
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 8934266-3501 (UT)
- Practice address
- 2180 S 1450 W
Wellsville, UT 84339-6733 - Phone
- (801) 695-5520
- NPI assigned
- Aug 29, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- McLeod Medical Centers of NM Inc
Practice addresses (Care Compare)
12127B N Hwy 14
Suite 5
Cedar Crest, NM 87008-9557
Phone (505) 281-5180
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241226002707 | NM | Practitioner - Clinical Social Worker | 5597292847 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8934266-3501 | UT | MD | Counselor |
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
Specialties & licenses
| 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 | Yes |
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
- Amanda Marie Takacs
Other providers in Wellsville, UT
- Tyler J Hunt
- Joshua Mark King
- Littlebug Occupational Therapy, LLC
- Michael Andrew Montgomery
- MTD Medical Services, LLC
- Bridget Rhoten
- Sherwood Hills Recovery Resort
- McKell Rose Stephens
- Trenton Stevens
- Tara Stireman
All providers in Wellsville, UT · Clinical Social Worker in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.