Individual provider Active NPI

Amanda Elaine Richardson, LPC

  • Professional Counselor
  • Columbia, SC
National Provider Identifier
1073114666
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
9975 Issued in SC
Practice address
4605 Monticello Rd Ste 3
Columbia, SC 29203-4156
Phone
(803) 754-0151
Fax
(803) 691-1778
NPI assigned
Nov 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 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 A15937 NC
Professional Counselor 101YP2500X 9975 SC Primary

Addresses

Primary practice location

4605 Monticello Rd Ste 3
Columbia, SC 29203-4156

Mailing address

169 Laurelhurst Ave
Columbia, SC 29210-3825
Phone (803) 733-5969

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20240821000861 SC Practitioner - Mental Health Counselor 3173061181 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A15937NCMDMental Health Counselor
9975SCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Eau Claire Cooperative Health Center, Inc. CurrentSince Jul 18, 2024 Accepting new patients
Eau Claire Cooperative Health Center ,Inc. CurrentSince Jul 18, 2024 Accepting new patients
Pediatrics of Newberry, LLC PastSince Jun 23, 2024 Accepting new patients

Locations

4605 Monticello Rd
Ste 3
Columbia, SC 29203
Phone (803) 754-0151

4605 Monticello Rd
Columbia, SC 29203
Phone (803) 252-7001

169 Laurelhurst Ave
Columbia, SC 29210
Phone (803) 730-0742

Organizations & group practices 3

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": "1604275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1073114666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 LAURELHURST AVE",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292103825",
            "telephone_number": "803-733-5969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 MONTICELLO RD STE 3",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292034156",
            "telephone_number": "803-754-0151",
            "fax_number": "803-691-1778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "AMANDA",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-02",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A15937",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "9975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.