Individual provider Active NPI

Amanda Wells, LMHC #9708

  • Addiction (Substance Use Disorder) Counselor
  • Malden, MA
National Provider Identifier
1083036958
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
30 Daniels St Apt 407
Malden, MA 02148-4218
Phone
(617) 980-1093
NPI assigned
Jan 13, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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 9708 MA
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

30 Daniels St Apt 407
Malden, MA 02148-4218

Mailing address

33 Maple St
Watertown, MA 02472-4605
Phone (617) 980-1093

Other names 1

  • Amanda Wells Professional 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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1389571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1083036958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 MAPLE ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024724605",
            "telephone_number": "617-980-1093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 DANIELS ST APT 407",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021484218",
            "telephone_number": "617-980-1093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "AMANDA",
        "credential": "LMHC #9708",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-13",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "9708",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "WELLS",
            "credential": "LMHC #9708",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Malden, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; 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.