Individual provider Active NPI

Amanda Kay Lewis, LCPC, CADC

  • Mental Health Counselor
  • Meridian, ID
National Provider Identifier
1205472370
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LCPC-8331097 Issued in ID
Practice address
1407 W McMillan Rd Ste 120
Meridian, ID 83646-5168
Phone
(208) 315-6717
Fax
(208) 315-6718
NPI assigned
Nov 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X LPC-7988 ID
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X LCPC-8331097 ID Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 11506 ID

Addresses

Primary practice location

1407 W McMillan Rd Ste 120
Meridian, ID 83646-5168

Mailing address

PO Box 1662
Meridian, ID 83680-1662
Phone (208) 315-6717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20241107001856 ID Practitioner - Mental Health Counselor 4789116765 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
Group practices
Restoring Hope - Healing From Trauma and AddictionGroup PAC ID 2961822754, 5 clinicians

Practice addresses (Care Compare)

1407 W McMillan Rd
Suite 120
Meridian, ID 83646-5168
Phone (208) 204-1099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11506IDMDAddiction (Substance Use Disorder) Counselor
LCPC-8331097IDMDMental Health Counselor
LPC-7988IDMDMental Health Counselor

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": "1574380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1205472370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1662",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836801662",
            "telephone_number": "208-315-6717",
            "fax_number": "208-315-6718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 W MCMILLAN RD STE 120",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836465168",
            "telephone_number": "208-315-6717",
            "fax_number": "208-315-6718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "AMANDA",
        "middle_name": "KAY",
        "credential": "LCPC, CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-22",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LPC-7988",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-8331097",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ID",
            "license": "11506",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.