Individual provider Active NPI

Amanda Mosher, LMHC, NCC

  • Mental Health Counselor
  • Commack, NY
National Provider Identifier
1164136263
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
014414 Issued in NY
Practice address
368 Veterans Memorial Hwy Ste 3
Commack, NY 11725-4322
Phone
(631) 533-0315
Fax
(855) 752-5170
NPI assigned
Jan 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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 014414 NY Primary

Addresses

Primary practice location

368 Veterans Memorial Hwy Ste 3
Commack, NY 11725-4322

Mailing address

368 Veterans Memorial Hwy Ste 3
Commack, NY 11725-4322
Phone (631) 533-0315

Other practice location 1

65 Air Park Dr Ste 10
Ronkonkoma, NY 11779-7374
Phone (631) 533-0315

Other practice location 2

380 N Broadway Ph E
Jericho, NY 11753-2198
Phone (631) 533-0315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240926000751 NY Practitioner - Mental Health Counselor 1759822083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sean Tendler Mental Health Counseling PCGroup PAC ID 8022559475, 11 clinicians

Practice addresses (Care Compare)

368 Veterans Memorial Hwy
Suite 3
Commack, NY 11725-4322
Phone (631) 533-0315

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
014414NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sean Tendler Mental Health Counseling, P.C. Mental Health CurrentSince Aug 13, 2024 Accepting new patients

Locations

368 Veterans Memorial Hwy
Ste 3
Commack, NY 11725
Phone (631) 533-0315

380 N Broadway
Ph E
Jericho, NY 11753
Phone (631) 533-0315

65 Air Park Dr
Ste 10
Ronkonkoma, NY 11779
Phone (631) 533-0315

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1673481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1164136263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "368 VETERANS MEMORIAL HWY STE 3",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254322",
            "telephone_number": "631-533-0315",
            "fax_number": "855-752-5170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "368 VETERANS MEMORIAL HWY STE 3",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254322",
            "telephone_number": "631-533-0315",
            "fax_number": "855-752-5170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "65 Air Park Dr Ste 10",
            "address_purpose": "LOCATION",
            "city": "Ronkonkoma",
            "state": "NY",
            "postal_code": "117797374",
            "country_code": "US",
            "telephone_number": "631-533-0315",
            "fax_number": "855-752-5170",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "380 N Broadway Ph E",
            "address_purpose": "LOCATION",
            "city": "Jericho",
            "state": "NY",
            "postal_code": "117532198",
            "country_code": "US",
            "telephone_number": "631-533-0315",
            "fax_number": "855-752-5170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSHER",
        "first_name": "AMANDA",
        "credential": "LMHC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-12",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "014414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

Verify at the official NPI Registry.