Individual provider Active NPI

Amanda Stickney, M.A., L.M.H.C.

  • Mental Health Counselor
  • Tavares, FL
National Provider Identifier
1285072124
Registry record updated Nov 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH11878 Issued in FL
Practice address
123 N Sinclair Ave
Tavares, FL 32778-3229
Phone
(727) 502-3864
NPI assigned
Jun 13, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH11878 FL Primary

Addresses

Primary practice location

123 N Sinclair Ave
Tavares, FL 32778-3229

Mailing address

399 E Burleigh Blvd Unit 392
Tavares, FL 32778-7517
Phone (727) 490-8936

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL STICKNEYMHC@gmail.com Other

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MH11878FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1371081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669507200000",
    "number": "1285072124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 E BURLEIGH BLVD UNIT 392",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327787517",
            "telephone_number": "727-490-8936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 N SINCLAIR AVE",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327783229",
            "telephone_number": "727-502-3864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STICKNEY",
        "first_name": "AMANDA",
        "credential": "M.A., L.M.H.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-13",
        "last_updated": "2022-11-27",
        "certification_date": "2022-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH11878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "STICKNEYMHC@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Email Address",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "email",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "123 N Sinclair Ave",
            "city": "Tavares",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327783229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tavares, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2022; 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.