Amanda Mincey
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Archie, MO
NPI 1316632508 · NPPES record last updated Apr 5, 2023
Key facts
- NPI
- 1316632508
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 11201 (MO)
- Practice address
- 302 S Main St
Archie, MO 64725-9608 - Phone
- (816) 372-2948
- NPI assigned
- Apr 5, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11201 | MO | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 11201 | MO | Yes |
Addresses
Primary practice location
302 S Main St
Archie, MO 64725-9608
Mailing address
802 S Main St
Clinton, MO 64735-2624
Other providers in Archie, MO
- Cass Regional Medical Center
- Cass Regional Medical Center
- Code 1 Wellness
- Tara Goosey
- Serenity E Hessenflow
- Emlyn Ann Salamone
All providers in Archie, MO · Addiction (Substance Use Disorder) Counselor in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.