Active NPI
Amanda Lo
- Mental Health Counselor
- Sun Prairie, WI
National Provider Identifier
1104552678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 132067-121
- Practice address
- 1268 W Main St
Sun Prairie, WI 53590-1930 - Phone
- (834) 608-1122
- NPI assigned
- Jul 27, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 132067-121 | WI | Primary |
Addresses
Primary practice location
1268 W Main St
Sun Prairie, WI 53590-1930
Mailing address
1268 W Main St
Sun Prairie, WI 53590-1930
Phone (834) 608-1122
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 132067-121 | WI | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658880000000",
"number": "1104552678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1268 W MAIN ST",
"city": "SUN PRAIRIE",
"state": "WI",
"postal_code": "535901930",
"telephone_number": "834-608-1122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1268 W MAIN ST",
"city": "SUN PRAIRIE",
"state": "WI",
"postal_code": "535901930",
"telephone_number": "834-608-1122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LO",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-27",
"last_updated": "2022-07-27",
"certification_date": "2022-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WI",
"license": "132067-121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sun Prairie, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.