Individual provider Active NPI

Amanda Goodwin, LPCC

  • Mental Health Counselor
  • Minneapolis, MN
National Provider Identifier
1386437804
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4962 Issued in MN
Practice address
822 S 3Rd St Ste 100
Minneapolis, MN 55415-1200
Phone
(612) 217-1667
Fax
(612) 324-1864
NPI assigned
May 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 4962 MN Primary

Addresses

Primary practice location

822 S 3Rd St Ste 100
Minneapolis, MN 55415-1200

Mailing address

2100 Pleasant Ave Apt 104
Minneapolis, MN 55404-2317
Phone (219) 776-7465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4962MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota Trauma Recovery Institute CurrentSince Jun 3, 2025 Accepting new patients
RS Eden PastSince Jun 3, 2025 Accepting new patients

Locations

822 S 3rd St
Ste 100
Minneapolis, MN 55415
Phone (612) 217-4002

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1748304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1386437804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 PLEASANT AVE APT 104",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554042317",
            "telephone_number": "219-776-7465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 S 3RD ST STE 100",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151200",
            "telephone_number": "612-217-1667",
            "fax_number": "612-324-1864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "AMANDA",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-27",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "4962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; 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.