Amanda Lissner Bergquist

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

5000774 Issued in MA

Practice address

303 Beech St
Holyoke, MA 01040-3968

Phone

(413) 540-1155

NPI assigned

Jul 10, 2019

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

River Valley Counseling Center IncGroup PAC ID 4981694999, 57 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/rvccinc/r4/

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.

• River Valley Counseling Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Holyoke, MA
  • NPI 1851444616
  Medicare reassignment Care Compare group NPD
• River Valley Counseling Center, Inc

  • Community/Behavioral Health Agency
  • Holyoke, MA
  • NPI 1003266727
  NPD (past)

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

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1164074241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 MAIN ST",
            "city": "HAMPDEN",
            "state": "MA",
            "postal_code": "010369640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 BEECH ST",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010403968",
            "telephone_number": "413-540-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGQUIST",
        "first_name": "AMANDA",
        "middle_name": "LISSNER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-10",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "5000774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RIVER VALLEY COUNSELING CENTER",
            "identifier": "1851444616",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dominique Bennefield
• Judith Bennett, MBA, RN
• Temika Bennett, LPN
• Shelly R. Benoit, LMHC
• Iyit Benusia
• Caira Berly
• Abigail Bernd
• Vanessa Bernecer
• Carly Siano Berneche, DNP, FNP
• Paulette Marie Berrocales, MSW

• Mental Health Counselor in Holyoke, MA
• Providers in Holyoke, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; 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.