Active NPI
Amber Banta, LCMHC
- Mental Health Counselor
- Burlington, VT
National Provider Identifier
1407563810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 068.0134865
- Practice address
- 125 Saint Paul St Ste 106
Burlington, VT 05401-8686 - Phone
- (802) 276-1030
- NPI assigned
- Nov 4, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 068.0134865 | VT | Primary |
Addresses
Primary practice location
125 Saint Paul St Ste 106
Burlington, VT 05401-8686
Mailing address
105 Depot St Unit 1034
Stowe, VT 05672-7442
Phone (802) 276-1030
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | https://www.vermontwellness.org | Vermont Wellness Collaborative LLC | |
| CONNECT URL | https://alpenglowcounselingvt.clientsecure.me | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 068.0134865 | VT | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695600000000",
"number": "1407563810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 DEPOT ST UNIT 1034",
"city": "STOWE",
"state": "VT",
"postal_code": "056727442",
"telephone_number": "802-276-1030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 SAINT PAUL ST STE 106",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054018686",
"telephone_number": "802-276-1030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANTA",
"first_name": "AMBER",
"credential": "LCMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-11-04",
"last_updated": "2023-09-25",
"certification_date": "2023-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VT",
"license": "068.0134865",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "https://www.vermontwellness.org",
"affiliation": "Y",
"endpointDescription": "Website",
"affiliationName": "Vermont Wellness Collaborative LLC",
"address_1": "125 Saint Paul St Ste 108",
"city": "Burlington",
"state": "VT",
"country_code": "US",
"postal_code": "054018462",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://alpenglowcounselingvt.clientsecure.me",
"affiliation": "N",
"endpointDescription": "Simple Practice Portal",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "125 Saint Paul St Ste 106",
"city": "Burlington",
"state": "VT",
"country_code": "US",
"postal_code": "054018686",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Burlington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.