Amanda Rau McKenna

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

005571 Issued in CT

Practice address

5 Seabreeze Rd
Old Saybrook, CT 06475-2723

Phone

(860) 209-6165

NPI assigned

Aug 14, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Mental Health Counselor

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stokes Counseling Services LLCGroup PAC ID 9638504202, 43 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Stokes Counseling Services LLC

  • Professional Counselor
  • Naugatuck, CT
  • NPI 1134541469
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1660435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660435200000",
    "number": "1124756440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SEABREEZE RD",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064752723",
            "telephone_number": "860-209-6165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 SEABREEZE RD",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064752723",
            "telephone_number": "860-209-6165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "AMANDA",
        "middle_name": "RAU",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-14",
        "last_updated": "2022-08-14",
        "certification_date": "2022-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "005571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "SOAPURL",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5 Seabreeze Rd",
            "city": "Old Saybrook",
            "state": "CT",
            "country_code": "US",
            "postal_code": "064752723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Artem Matatov
• Matthew J. Hoffman, LMFT, LLC
• Cynthia T. Matthew, PH.D.
• MC Diagnostic of Connecticut, P.C.
• James R McAraw, D.M.D.
• Craig Edward McKnight, M.D.
• Michelle McLain, LPC
• Kenyatia McLish, LMT
• Garth Eric Meadows, R.PH.
• Medical Center Pharmacy and Home Care Center, Inc.

• Professional Counselor in Old Saybrook, CT
• Providers in Old Saybrook, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.