Amanda Wisian, LPC, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0998730 Issued in CO

Practice address

10160 W 50TH Ave Unit 4
Wheat Ridge, CO 80033-2339

Phone

(720) 669-3470

NPI assigned

Oct 31, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 8

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Excalibur Psychiatric Services

  • Psychiatric/Mental Health Nurse Practitioner
  • Cedar Rapids, IA
  • NPI 1346100229
  NPD Authorized official
• Forte Health and Wellness Inc

  • General Practice Physician
  • Denver, CO
  • NPI 1447888797

  Psychiatry

  NPD
• Lee & Me Psychiatry, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Greenwood Village, CO
  • NPI 1548929003

  Professional

  NPD (past)

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

{
    "created_epoch": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1306190202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8181 E TUFTS AVE STE 560",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802372559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10160 W 50TH AVE UNIT 4",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800332339",
            "telephone_number": "720-669-3470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1455 Dixon Ave",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "CO",
            "postal_code": "800268879",
            "country_code": "US",
            "telephone_number": "303-443-8500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "791 Chambers Rd",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800117112",
            "country_code": "US",
            "telephone_number": "303-617-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISIAN",
        "first_name": "AMANDA",
        "credential": "LPC, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-31",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "RN.1659896",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "0011133",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CO",
            "license": "1659896",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CO",
            "license": "RN.1659896",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "UT",
            "license": "7142009-6004",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WA",
            "license": "LH 60290236",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "0011133",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "0998730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Jean Wimmer, CPNP
• Kelli Windholz
• Aaron Winkelman
• Frances Eleanor Winslow
• April J Wise, BS, CAC I
• Michael S Wisniewski, MD
• Jeffrey Witt, RN
• McKinnley Sarai Witty, MSW
• Barbara S Wolf
• Beth G Wolf, OTR, CHT,CEASII

• Psychiatric/Mental Health Nurse Practitioner in Wheat Ridge, CO
• Providers in Wheat Ridge, CO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.