Amanda Jane McCullough, PLMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

2021016981 Issued in MO

Practice address

807 NW 975TH Rd
Centerview, MO 64019-9134

Phone

(801) 390-4227

NPI assigned

Feb 11, 2022

Last updated

Mar 25, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Honey Creek Counseling LLC

  • Marriage & Family Therapist
  • Centerview, MO
  • NPI 1285384040
  NPD Authorized official

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

{
    "created_epoch": "1644537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1386398980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 E MARKET ST",
            "city": "WARRENSBURG",
            "state": "MO",
            "postal_code": "640931820",
            "telephone_number": "660-864-0904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 NW 975TH RD",
            "city": "CENTERVIEW",
            "state": "MO",
            "postal_code": "640199134",
            "telephone_number": "801-390-4227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "AMANDA",
        "middle_name": "JANE",
        "credential": "PLMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-11",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MO",
            "license": "2021016981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Helen Alexis Fuemmeler Melloy
• Elaine Hebensperger
• Home Rehabilitation and Consultant Services, PC
• Honey Creek Counseling LLC
• Johnson County R-7 School District
• Laurie Anne Rose, MSED PT
• Jessi B Shane, PTA
• Martha Jo Shook, MSW PT
• Show Me Independent Living Extended Services, L.L.C. (Smiles)
• True Support Together LLC

• Marriage & Family Therapist in Centerview, MO
• Providers in Centerview, MO by specialty
• Marriage & Family Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.