Individual provider Active NPI

Amanda Jo Thomas, LCMHC, LPC

  • Mental Health Counselor
  • Sanford, NC
National Provider Identifier
1215313879
Registry record updated Aug 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
12380 Issued in NC
Practice address
304 N Horner Blvd
Sanford, NC 27330-3939
Phone
(919) 897-5111
Fax
(888) 972-8390
NPI assigned
Aug 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 12380 NC Primary
Mental Health Counselor 101YM0800X 5451 TN

Addresses

Primary practice location

304 N Horner Blvd
Sanford, NC 27330-3939

Mailing address

304 N Horner Blvd
Sanford, NC 27330-3939
Phone (919) 897-5111

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
12380NCMDMental Health Counselor
5451TNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Verna Dority, MSW, CCSW, Inc PastSince Aug 4, 2024 Accepting new patients

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": "1438819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722643200000",
    "number": "1215313879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 N HORNER BLVD",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273303939",
            "telephone_number": "919-897-5111",
            "fax_number": "888-972-8390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 N HORNER BLVD",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273303939",
            "telephone_number": "919-897-5111",
            "fax_number": "888-972-8390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "AMANDA",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "LCMHC, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-06",
        "last_updated": "2024-08-03",
        "certification_date": "2024-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "12380",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "5451",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2024; 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.