Active NPI
Amanda Jordan Carter, MA, LPC
- Professional Counselor
- Cartersville, GA
National Provider Identifier
1346563012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC005368
- Practice address
- 30C Fox Chase
Cartersville, GA 30120-2491 - Phone
- (678) 721-2249
- Fax
- (678) 721-2424
- NPI assigned
- Mar 9, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC005368 | GA | Primary |
Addresses
Primary practice location
30C Fox Chase
Cartersville, GA 30120-2491
Mailing address
2618 Marleigh Farm Rd NW
Kennesaw, GA 30152-6520
Phone (404) 895-9699
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC005368 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268092800000",
"number": "1346563012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2618 MARLEIGH FARM RD NW",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301526520",
"telephone_number": "404-895-9699",
"fax_number": "678-721-2424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30C FOX CHASE",
"city": "CARTERSVILLE",
"state": "GA",
"postal_code": "301202491",
"telephone_number": "678-721-2249",
"fax_number": "678-721-2424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARTER",
"first_name": "AMANDA",
"middle_name": "JORDAN",
"credential": "MA, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-09",
"last_updated": "2010-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC005368",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cartersville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.