Individual provider Active NPI

Amanda Louise Boblitz-McFadden, LCPC

  • Professional Counselor
  • Edgewood, MD
National Provider Identifier
1063714913
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC5023 Issued in MD
Practice address
502 Orchid CT
Edgewood, MD 21040-3550
Phone
(443) 243-4140
NPI assigned
Nov 29, 2010
Last updated
Nov 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

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 LC5023 MD
Professional Counselor 101YP2500X LC5023 MD Primary

Addresses

Primary practice location

502 Orchid CT
Edgewood, MD 21040-3550

Mailing address

502 Orchid Court
Edgewood, MD 21040
Phone (443) 243-4140

Other names 1

  • Amanda Louise Boblitz Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LC5023MDMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1290988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1063714913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 ORCHID COURT",
            "city": "EDGEWOOD",
            "state": "MD",
            "postal_code": "21040",
            "telephone_number": "443-243-4140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 ORCHID CT",
            "city": "EDGEWOOD",
            "state": "MD",
            "postal_code": "210403550",
            "telephone_number": "443-243-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBLITZ-MCFADDEN",
        "first_name": "AMANDA",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-29",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC5023",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC5023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "BOBLITZ",
            "middle_name": "LOUISE",
            "credential": "LCPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Edgewood, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.