Amy Anderson, M.ED LPC, LADC
Individual provider Active NPI Professional Counselor · Stillwater, OK
NPI 1104174994 · NPPES record last updated Feb 13, 2024
Key facts
- NPI
- 1104174994
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 5332 (OK)
- Practice address
- 2506 N Redlands Rd
Stillwater, OK 74075-2044 - Phone
- (405) 213-7376
- NPI assigned
- Aug 27, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Talkspace Provider Network PA
Practice addresses (Care Compare)
11100 E 96TH St S
Apt 1131
Tulsa, OK 74133-5473
Phone (702) 524-4162
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (4 enrollments) in OK, VT, AZ, FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240318000263 | OK | Practitioner - Mental Health Counselor | 2264876432 |
Reassigns benefits to 1 organization Practice locations: Stillwater, OK |
| I20250903003010 | VT | Practitioner - Mental Health Counselor | 2264876432 | Reassigns benefits to 1 organization |
| I20260204002541 | AZ | Practitioner - Mental Health Counselor | 2264876432 | Reassigns benefits to 1 organization |
| I20260209004107 | FL | Practitioner - Mental Health Counselor | 2264876432 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5332 | OK | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Talkspace Provider Network PA | Current |
Accepting new patients | |
| Net Counseling Services LLC | Past | Accepting new patients |
Locations
2578 Broadway
Ste 607
New York, NY 10025
Phone (304) 308-3735
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Professional Counselor | 101YP2500X | 5332 | OK | Yes |
Addresses
Primary practice location
2506 N Redlands Rd
Stillwater, OK 74075-2044
Mailing address
2506 N Redlands Rd
Stillwater, OK 74075-2044
Phone (405) 213-7376
Other providers in Stillwater, OK
- Shayleigh Brooke Allison
- Doaa Altameemi
- Broghan Altermatt
- Amber T Lewis LPC PLLC
- Shelby Nicole Amey
- James H. Anderson
- Jim A Anderson
- Karen Anderson
- Kaylie Marie Anderson
- Rachel Pauline Anderson
All providers in Stillwater, OK · Professional Counselor in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.