Active NPI
Amanda Chick
- Case Manager/Care Coordinator
- Olympia, WA
National Provider Identifier
1124597695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 200 Lilly Rd NE Ste C
Olympia, WA 98506-5080 - Phone
- (360) 918-8336
- NPI assigned
- Nov 14, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 101YM0800X | WA | |
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
200 Lilly Rd NE Ste C
Olympia, WA 98506-5080
Mailing address
22521 Crown Cir SE
Yelm, WA 98597-9335
Phone (913) 948-0096
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101YM0800X | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566777600000",
"number": "1124597695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22521 CROWN CIR SE",
"city": "YELM",
"state": "WA",
"postal_code": "985979335",
"telephone_number": "913-948-0096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 LILLY RD NE STE C",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985065080",
"telephone_number": "360-918-8336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHICK",
"first_name": "AMANDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-11-14",
"last_updated": "2019-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "101YM0800X",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.