Individual provider Active NPI

Amanda Lee Burg, LADC

  • Addiction (Substance Use Disorder) Counselor
  • North Mankato, MN
National Provider Identifier
1144731001
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
304479 Issued in MN
Practice address
1826 Commerce Dr
North Mankato, MN 56003-1800
Phone
(507) 229-0350
NPI assigned
Oct 18, 2017
Last updated
Oct 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 304479 MN Primary

Addresses

Primary practice location

1826 Commerce Dr
North Mankato, MN 56003-1800

Mailing address

1826 Commerce Dr
North Mankato, MN 56003-1800
Phone (507) 290-3502

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

LicenseStateTypeSpecialty
304479MNMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mankato Chemical Health, LLC Addiction (Substance Use Disorder) CurrentSince Oct 29, 2023 Accepting new patients

Locations

1826 Commerce Dr
North Mankato, MN 56003
Phone (507) 229-0350

360 Pierce Ave
Ste 206
North Mankato, MN 56003
Phone (507) 229-0350

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1508284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1144731001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1826 COMMERCE DR",
            "city": "NORTH MANKATO",
            "state": "MN",
            "postal_code": "560031800",
            "telephone_number": "507-290-3502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1826 COMMERCE DR",
            "city": "NORTH MANKATO",
            "state": "MN",
            "postal_code": "560031800",
            "telephone_number": "507-229-0350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURG",
        "first_name": "AMANDA",
        "middle_name": "LEE",
        "credential": "LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-18",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "304479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Mankato, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.