Individual provider Active NPI

Amanda L Bosley, LGPC

  • Professional Counselor
  • Oakland, MD
National Provider Identifier
1306540505
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC14765 Issued in MD
Practice address
1025 Memorial Dr
Oakland, MD 21550-4343
Phone
(301) 334-7680
Fax
(301) 334-7681
NPI assigned
Mar 30, 2023
Last updated
Jan 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LGP11188 MD
Professional Counselor 101YP2500X LC14765 MD Primary

Addresses

Primary practice location

1025 Memorial Dr
Oakland, MD 21550-4343

Mailing address

1025 Memorial Dr
Oakland, MD 21550-4343
Phone (301) 334-7680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20240205003498 MD Practitioner - Mental Health Counselor 7911340153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Garrett County Health DepartmentGroup PAC ID 0547239626, 14 clinicians

Practice addresses (Care Compare)

1025 Memorial Dr
Oakland, MD 21550-4343
Phone (301) 334-7700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LGP11188MDMDMental Health Counselor
LC14765MDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Garrett County Health Dept-Substance Abuse CurrentSince Jan 24, 2024 Accepting new patients
Garrett County Health Department CurrentSince Jan 24, 2024 Accepting new patients

Locations

1025 Memorial Dr
Oakland, MD 21550
Phone (301) 334-7680

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1680134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1306540505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MEMORIAL DR",
            "city": "OAKLAND",
            "state": "MD",
            "postal_code": "215504343",
            "telephone_number": "301-334-7680",
            "fax_number": "301-334-7681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MEMORIAL DR",
            "city": "OAKLAND",
            "state": "MD",
            "postal_code": "215504343",
            "telephone_number": "301-334-7680",
            "fax_number": "301-334-7681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSLEY",
        "first_name": "AMANDA",
        "middle_name": "L",
        "credential": "LGPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-30",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LGP11188",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC14765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, MD

Sources for this page

Verify at the official NPI Registry.