Individual provider Active NPI

Amanda L Miller-Hodges, LMHC, C-DBT

  • Mental Health Counselor
  • Fernandina Beach, FL
National Provider Identifier
1073852828
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH20864 Issued in FL
Practice address
1903 Island Walk Way
Fernandina Beach, FL 32034-4797
Phone
(904) 277-0027
Fax
(407) 867-6261
NPI assigned
Feb 13, 2013
Last updated
Feb 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2023

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 MH20864 FL Primary
Social Worker 104100000X NU

Addresses

Primary practice location

1903 Island Walk Way
Fernandina Beach, FL 32034-4797

Mailing address

1903 Island Walk Way
Fernandina Beach, FL 32034-4797
Phone (904) 277-0027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240306000639 FL Practitioner - Mental Health Counselor 6800232422 Reassigns benefits to 1 organization
I20260220000193 GA Practitioner - Mental Health Counselor 6800232422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Feb 1, 2024 Accepting new patients
Florida Psychological & Associated Healthcare Past Accepting new patients
Shine Medical Providers PC Past Accepting new patients
Florida Psychological Associates, LLC Social Worker PastSince Sep 8, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

715 Peachtree St NE
Ste 100
Atlanta, GA 30308
Phone (202) 972-4964

Organizations & group practices 4

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": "1360713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1073852828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 ISLAND WALK WAY",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320344797",
            "telephone_number": "904-277-0027",
            "fax_number": "407-867-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 ISLAND WALK WAY",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320344797",
            "telephone_number": "904-277-0027",
            "fax_number": "407-867-6261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER-HODGES",
        "first_name": "AMANDA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LMHC, C-DBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-13",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH20864",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fernandina Beach, FL

Sources for this page

Verify at the official NPI Registry.