Active NPI
Amanda Crawford
- Professional Counselor
- Johnson City, TN
National Provider Identifier
1356080964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4944
- Practice address
- 2700 S Roan St Ste 105
Johnson City, TN 37601-7679 - Phone
- (423) 631-0210
- NPI assigned
- Jun 1, 2022
- Sex
- Female
- Sole proprietor
- No
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 | 4944 | TN | Primary |
Addresses
Primary practice location
2700 S Roan St Ste 105
Johnson City, TN 37601-7679
Mailing address
2700 S Roan St Ste 105
Johnson City, TN 37601-7679
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260626002433 | TN | Practitioner - Mental Health Counselor | 3577036987 | Practice locations: Johnson City, TN |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
176 Village LN
Johnson City, TN 37615-3720
207 N Boone St
Suite 6
Johnson City, TN 37604-5696
Phone (423) 579-2762
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4944 | TN | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654041600000",
"number": "1356080964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2700 S ROAN ST STE 105",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376017679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 S ROAN ST STE 105",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376017679",
"telephone_number": "423-631-0210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRAWFORD",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-01",
"last_updated": "2022-06-01",
"certification_date": "2022-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TN",
"license": "4944",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.