Individual provider Active NPI

Amanda Kathleen Chipman, LIMHP, LPC, LCMHC

  • Mental Health Counselor
  • Omaha, NE
National Provider Identifier
1396593836
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3180 Issued in NE
Practice address
2323 Avenue J E
Omaha, NE 68110-2789
Phone
(402) 522-7190
NPI assigned
May 9, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 20100 NC
Mental Health Counselor 101YM0800X 9652 SC
Mental Health Counselor 101YM0800X 3180 NE Primary

Addresses

Primary practice location

2323 Avenue J E
Omaha, NE 68110-2789

Mailing address

1815 Longview St # B-103
Papillion, NE 68133-2538
Phone (402) 314-4713

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20240815001124 NC Practitioner - Mental Health Counselor 1759829260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MonarchGroup PAC ID 0244273852, 92 clinicians

Practice addresses (Care Compare)

350 Pee Dee Ave
Suite 101
Albemarle, NC 28001-4945
Phone (704) 986-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3180NEMDSpecialist
9652SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Monarch Current Accepting new patients
Monarch CurrentSince Jun 4, 2024 Accepting new patients
Monarch CurrentSince Jun 4, 2024 Accepting new patients
Monarch Past Accepting new patients

Locations

350 Pee Dee Ave
Ste 101
Albemarle, NC 28001
Phone (704) 986-1522

3057 Freedom Dr
Charlotte, NC 28208
Phone (704) 334-2226

820 Grimes Blvd
Lexington, NC 27292
Phone (336) 224-6071

Organizations & group practices 4

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": "1715212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1396593836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 LONGVIEW ST # B-103",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "681332538",
            "telephone_number": "402-314-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 AVENUE J E",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681102789",
            "telephone_number": "402-522-7190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIPMAN",
        "first_name": "AMANDA",
        "middle_name": "KATHLEEN",
        "credential": "LIMHP, LPC, LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-09",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "20100",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "9652",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "3180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.