Individual provider Active NPI

Amanda Marlowe Wilkins, LCMHC, NCC

  • Mental Health Counselor
  • Whiteville, NC
National Provider Identifier
1396971396
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2118 Issued in NC
Practice address
102 W Main St Ste a
Whiteville, NC 28472-4012
Phone
(910) 518-0432
Fax
(910) 207-6326
NPI assigned
Jun 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2118 NC
Mental Health Counselor 101YM0800X 2118 NC Primary

Addresses

Primary practice location

102 W Main St Ste a
Whiteville, NC 28472-4012

Mailing address

117 E Oliver St
Whiteville, NC 28472-2719
Phone (910) 642-8393

Other identifiers 1

IdentifierTypeStateIssuer
6104293MedicaidNC

Other names 1

  • Miss Carrie Amanda Marlowe Other name

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
I20240822004042 NC Practitioner - Mental Health Counselor 6406172352 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2118NCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Pace Health Network, LLC CurrentSince Jul 17, 2024 Accepting new patients
Wilmar Counseling, PLLC CurrentSince Mar 1, 2015 Accepting new patients
Waccamaw Associates Mental Health Past Accepting new patients

Locations

102 W Main St
Ste A
Whiteville, NC 28472
Phone (910) 642-7463

209 W Virgil St
Whiteville, NC 28472
Phone (910) 640-2430

Organizations & group practices 3

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": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1396971396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 E OLIVER ST",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284722719",
            "telephone_number": "910-642-8393",
            "fax_number": "910-207-6326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W MAIN ST STE A",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284724012",
            "telephone_number": "910-518-0432",
            "fax_number": "910-207-6326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "AMANDA",
        "middle_name": "MARLOWE",
        "name_prefix": "Mrs.",
        "credential": "LCMHC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-03",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "2118",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "2118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6104293",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARRIE",
            "last_name": "MARLOWE",
            "middle_name": "AMANDA",
            "prefix": "MISS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Whiteville, NC

Sources for this page

Verify at the official NPI Registry.