Individual provider Active NPI

Amanda Soliven, LPCC

  • Professional Counselor
  • Mansfield, OH
National Provider Identifier
1396005633
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E1100020 Issued in OH
Practice address
151 Marion Ave
Mansfield, OH 44903-2223
Phone
(419) 774-9969
Fax
(419) 756-5642
NPI assigned
May 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E1100020 OH Primary

Addresses

Primary practice location

151 Marion Ave
Mansfield, OH 44903-2223

Mailing address

151 Marion Ave
Mansfield, OH 44903-2223
Phone (419) 774-9969

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240426001289 OH Practitioner - Mental Health Counselor 7315387107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

151 Marion Ave
Mansfield, OH 44903-2223
Phone (419) 774-9969

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E1100020OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Life Counseling & Psychiatric Services CurrentSince Mar 10, 2024 Accepting new patients
Family Life Counseling & Psychiatric Services CurrentSince Mar 10, 2024 Accepting new patients

Locations

151 Marion Ave
Mansfield, OH 44903
Phone (419) 774-9969

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": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1396005633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 MARION AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449032223",
            "telephone_number": "419-774-9969",
            "fax_number": "419-756-5642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 MARION AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449032223",
            "telephone_number": "419-774-9969",
            "fax_number": "419-756-5642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLIVEN",
        "first_name": "AMANDA",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-21",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E1100020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

Verify at the official NPI Registry.