Active NPI
Thomas John Amaya Sr., LCPC, LAC
- Counselor
- Guadalupe, AZ
National Provider Identifier
1386703106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 778
- Practice address
- 9405 S Avenida del Yaqui
Guadalupe, AZ 85283-2529 - Phone
- (480) 768-2000
- Fax
- (480) 768-2053
- NPI assigned
- Dec 7, 2006
- Last updated
- Feb 11, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 778 | MT | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1101 | MT |
Addresses
Primary practice location
9405 S Avenida del Yaqui
Guadalupe, AZ 85283-2529
Mailing address
4505 S Hardy Dr Apt 2121
Tempe, AZ 85282-6569
Phone (406) 239-8749
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0256989 | Medicaid | MT | |
| 778 | Other | MT | LICENSE FOR LCPC |
| 1101 | Other | MT | LICENSE FOR LAC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1101 | MT | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202688000000",
"number": "1386703106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4505 S HARDY DR APT 2121",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852826569",
"telephone_number": "406-239-8749",
"fax_number": "480-768-2053"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9405 S AVENIDA DEL YAQUI",
"city": "GUADALUPE",
"state": "AZ",
"postal_code": "852832529",
"telephone_number": "480-768-2000",
"fax_number": "480-768-2053"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMAYA",
"first_name": "THOMAS",
"middle_name": "JOHN",
"name_suffix": "Sr.",
"credential": "LCPC, LAC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-07",
"last_updated": "2008-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MT",
"license": "778",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MT",
"license": "1101",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0256989",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE FOR LCPC",
"identifier": "778",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE FOR LAC",
"identifier": "1101",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Guadalupe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.