Individual provider Active NPI

Amanda Delia, M.S LPC

  • Professional Counselor
  • Southport, CT
National Provider Identifier
1265122055
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6329 Issued in CT
Practice address
2960 Post Rd FL 3
Southport, CT 06890-1268
Phone
(203) 307-3030
NPI assigned
May 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6329 CT Primary

Addresses

Primary practice location

2960 Post Rd FL 3
Southport, CT 06890-1268

Mailing address

2960 Post Rd FL 3
Southport, CT 06890-1268

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20240925002701 CT Practitioner - Mental Health Counselor 5294276663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
WCT Behavioral Health and Medication Management PLLCGroup PAC ID 8820480734, 30 clinicians

Practice addresses (Care Compare)

211 Schraffts Dr
Lowr Level
Waterbury, CT 06705-3222
Phone (203) 518-8218

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
6323CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
WCT Behavioral Health & Medication Management PLLC CurrentSince Jun 17, 2024 Accepting new patients

Locations

211 Schraffts Dr
Lowr
Waterbury, CT 06705
Phone (203) 518-8218

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": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1265122055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 POST RD FL 3",
            "city": "SOUTHPORT",
            "state": "CT",
            "postal_code": "068901268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 POST RD FL 3",
            "city": "SOUTHPORT",
            "state": "CT",
            "postal_code": "068901268",
            "telephone_number": "203-307-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELIA",
        "first_name": "AMANDA",
        "credential": "M.S LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "6329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southport, CT

Sources for this page

Verify at the official NPI Registry.