Individual provider Active NPI

Amanda Brumfield

  • Mental Health Counselor
  • Gallipolis, OH
National Provider Identifier
1033635453
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E.2404821 Issued in OH
Practice address
3086 State Route 160
Gallipolis, OH 45631
Phone
(740) 446-5500
Fax
(740) 446-2159
NPI assigned
Aug 17, 2017
Last updated
Oct 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X E.2404821 OH Primary
Clinical Social Worker 1041C0700X S.1302526 OH

Addresses

Primary practice location

3086 State Route 160
Gallipolis, OH 45631

Mailing address

3086 State Route 160
Gallipolis, OH 45631-8409
Phone (740) 446-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241126000880 OH Practitioner - Mental Health Counselor 5890220933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2001
Medicare assignment
May accept Medicare assignment
Group practices
Smith Family Healthcare, LLPGroup PAC ID 3870861198, 3 clinicians

Practice addresses (Care Compare)

254 Pinecrest Dr
Gallipolis, OH 45631-1347
Phone (740) 578-4824

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S.1302526OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Smith Family Healthcare, LLP CurrentSince Nov 5, 2024 Accepting new patients

Locations

254 Pinecrest Dr
Gallipolis, OH 45631
Phone (740) 578-4824

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1502928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1033635453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3086 STATE ROUTE 160",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456318409",
            "telephone_number": "740-446-5500",
            "fax_number": "740-446-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3086 STATE ROUTE 160",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "45631",
            "telephone_number": "740-446-5500",
            "fax_number": "740-446-2159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUMFIELD",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-17",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.2404821",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.1302526",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallipolis, OH

Sources for this page

Verify at the official NPI Registry.