Amanda Marie Willis, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

400 S College
Ste 2
Mountain Home, AR 72653-3143

Phone

(870) 425-1041

Fax

(870) 425-1049

NPI assigned

Aug 10, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

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

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Families, Inc of ArkansasGroup PAC ID 9335133669, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Families, Inc of Arkansas

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jonesboro, AR
  • NPI 1770535569
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1407466923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 PLEASANT GROVE RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724057870",
            "telephone_number": "870-933-6886",
            "fax_number": "870-336-1339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S COLLEGE",
            "address_2": "STE 2",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726533143",
            "telephone_number": "870-425-1041",
            "fax_number": "870-425-1049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2023-12-29",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Williams, M.D.
• Randi D Williams, HIS
• Winifred Williams
• Andrew James Williamson, CCC-SLP
• Joshua Williamson, THM, QBHP
• Sybil Willis, LCSW
• Wilson Interventional Clinic PA
• Aubrey Wilson, LCSW
• Forrest Kane Wilson
• Jack Cook Wilson, M.D.

• Professional Counselor in Mountain Home, AR
• Providers in Mountain Home, AR by specialty
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.