Amanda Lynn Anderson, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CP012920 Issued in PA

Practice address

570 Lincoln Ave
Bellevue, PA 15202-3530

Phone

(724) 504-2767

NPI assigned

Dec 21, 2020

Sex

Female

Sole proprietor

No

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.

• Mentwell Inc.

  • Mental Health Counselor
  • Bellevue, PA
  • NPI 1518466044
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 30, 2024 through Oct 30, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

• Amanda L Anderson Professional name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 21, 2020.

{
    "created_epoch": "1608508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1366038671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 LINCOLN AVE",
            "city": "BELLEVUE",
            "state": "PA",
            "postal_code": "152023530",
            "telephone_number": "724-504-2767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 LINCOLN AVE",
            "city": "BELLEVUE",
            "state": "PA",
            "postal_code": "152023530",
            "telephone_number": "724-504-2767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "AMANDA",
        "middle_name": "LYNN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-21",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "CP012920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "therapynotes.com",
            "affiliation": "N",
            "endpointDescription": "electronic portal",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "570 Lincoln Ave",
            "city": "Bellevue",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152023530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "ANDERSON",
            "middle_name": "L",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Bellevue Chiropractic Centre, P.C.
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• All providers in Bellevue, PA
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2020; 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.

Verify at the official NPI Registry.