Individual provider Active NPI

Amanda Tanner, LCMHC

  • Mental Health Counselor
  • Burlington, VT
National Provider Identifier
1124417746
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0680105341 Issued in VT
Practice address
1138 Pine St
Burlington, VT 05401-5353
Phone
(802) 488-6600
Fax
(802) 488-6919
NPI assigned
Jan 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0680105341 VT Primary

Addresses

Primary practice location

1138 Pine St
Burlington, VT 05401-5353

Mailing address

102 S Winooski Ave
Burlington, VT 05401-7406
Phone (802) 488-6920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20231228003314 VT Practitioner - Mental Health Counselor 2062862352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
University of Vermont College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Howard Center IncGroup PAC ID 3072403831, 36 clinicians

Practice addresses (Care Compare)

1138 Pine St
Burlington, VT 05401-5353
Phone (802) 488-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0680105341VTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Howard Center Inc CurrentSince Jan 1, 2024 Accepting new patients
Howard Center Inc Current Accepting new patients
Howard Center Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

208 Flynn Ave
Ste 3J
Burlington, VT 05401
Phone (802) 488-6900

1138 Pine St
Burlington, VT 05401
Phone (802) 488-6600

102 S Winooski Ave
Burlington, VT 05401
Phone (802) 488-6920

300 Flynn Ave
Burlington, VT 05401
Phone (802) 488-6934

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": "1421712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1124417746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 S WINOOSKI AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054017406",
            "telephone_number": "802-488-6920",
            "fax_number": "802-488-6919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1138 PINE ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015353",
            "telephone_number": "802-488-6600",
            "fax_number": "802-488-6919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "AMANDA",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-20",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "0680105341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.