Individual provider Active NPI

Amanda Wiegert, LMHC

  • Mental Health Counselor
  • Maitland, FL
National Provider Identifier
1073030276
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH13124 Issued in FL
Practice address
100 E Sybelia Ave Ste 380
Maitland, FL 32751-4775
Phone
(407) 448-9521
NPI assigned
Aug 28, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X MH13124 FL Primary

Addresses

Primary practice location

100 E Sybelia Ave Ste 380
Maitland, FL 32751-4775

Mailing address

100 East Sybelia Avenue Suite 380
Maitland, FL 32751-4615
Phone (407) 448-9521

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
MH13124FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Amanda Wiegert, LLC Current Accepting new patients

Locations

100 E Sybelia Ave
Ste 380
Maitland, FL 32751
Phone (407) 353-1484

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1503878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1073030276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 EAST SYBELIA AVENUE SUITE 380",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514615",
            "telephone_number": "407-448-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E SYBELIA AVE STE 380",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514775",
            "telephone_number": "407-448-9521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEGERT",
        "first_name": "AMANDA",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-28",
        "last_updated": "2022-03-01",
        "certification_date": "2022-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH13124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2022; 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.