Amanda Christine Nellis, PH.D., LPC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

4016 Issued in AZ

Practice address

7301 N 16TH St Ste 102
Phoenix, AZ 85020-5266

Phone

(602) 734-0213

NPI assigned

Aug 9, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Clinical Psychologist

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1265442628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17080 W SAGUARO LN",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853881398",
            "telephone_number": "602-301-6670",
            "fax_number": "623-537-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 N 16TH ST STE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850205266",
            "telephone_number": "602-734-0213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELLIS",
        "first_name": "AMANDA",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "PH.D., LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "AZ",
            "license": "4016",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC-2216",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "579401",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nataly Neira
• Margaret L. Neish, RNC
• Patrick Neish
• Yelena Nektalova, PHARM.D.
• Nel'S Nest Assisted Living , LLC
• Nelson a. Villamor, M.D. P.C.
• Nelson and Makowsky LTD
• Kathy Nelson Hawks
• Nelson Life Centers
• Laurie Sue Nelson Wallace, OTR/L

• Counseling Psychologist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Counseling Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.