Amanda Wilder, LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

287211 Issued in KY

Practice address

115 Rockwood LN
Hazard, KY 41701-9415

Phone

(800) 575-7223

Fax

(606) 436-5797

NPI assigned

Aug 29, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

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.

• Kentucky River Community Care, Inc

  • Mental Health Counselor
  • Hazard, KY
  • NPI 1528017142
  Medicare reassignment NPD

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

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1316429129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 ROCKWOOD LN",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019415",
            "telephone_number": "800-575-7223",
            "fax_number": "606-436-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 ROCKWOOD LN",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019415",
            "telephone_number": "800-575-7223",
            "fax_number": "606-436-5797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDER",
        "first_name": "AMANDA",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-29",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "287221",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A14027",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "287211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheena Shenae White, APRN
• Willa Ruth White
• David T Whiting, DPM
• Mitchell Wicker Jr., MD
• Diana Wilder-Bennett
• Jennifer Wilder
• William B Gibson, DMD, PSC
• Alan Dale Williams, D.C.
• Allyson Nichole Williams, ARNP
• Amy Williams

• Mental Health Counselor in Hazard, KY
• Providers in Hazard, KY by specialty
• Mental Health Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.