Amanda Farmer Kissiah

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

122 E Home Ave
Hartsville, SC 29550-3712

Phone

(843) 917-0495

NPI assigned

Oct 3, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Amanda R Farmer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Teresa Redfearn LLC

  • Clinical Psychologist
  • Hartsville, SC
  • NPI 1689038325
  NPD

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

{
    "created_epoch": "1696291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1275313751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 E HOME AVE",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295503712",
            "telephone_number": "843-917-0495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 E HOME AVE",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295503712",
            "telephone_number": "843-917-0495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSIAH",
        "first_name": "AMANDA",
        "middle_name": "FARMER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-03",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "FARMER",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Counselor in Hartsville, SC
• Providers in Hartsville, SC by specialty
• Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.