Active NPI
Amanda Walden
- Counselor
- Dothan, AL
National Provider Identifier
1407621907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- ALC05182
- Practice address
- 5565 Montgomery Hwy
Dothan, AL 36303-1552 - Phone
- (334) 790-2489
- NPI assigned
- Nov 15, 2023
- Last updated
- Feb 14, 2025
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | ALC05182 | AL | Primary |
| Mental Health Counselor | 101YM0800X | APC009343 | GA |
Addresses
Primary practice location
5565 Montgomery Hwy
Dothan, AL 36303-1552
Mailing address
300 Coronada St
Enterprise, AL 36330-4506
Phone (850) 274-9082
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ALC05182 | AL | MD | Counselor |
| APC009343 | GA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1700006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739491200000",
"number": "1407621907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 CORONADA ST",
"city": "ENTERPRISE",
"state": "AL",
"postal_code": "363304506",
"telephone_number": "850-274-9082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5565 MONTGOMERY HWY",
"city": "DOTHAN",
"state": "AL",
"postal_code": "363031552",
"telephone_number": "334-790-2489"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDEN",
"first_name": "AMANDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-11-15",
"last_updated": "2025-02-14",
"certification_date": "2025-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "AL",
"license": "ALC05182",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "GA",
"license": "APC009343",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dothan, AL
- Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2534)
- Wal-Mart Stores East LP (Walmart Pharmacy 10-0604)
- Wal-Mart Stores East LP (Walmart Pharmacy 10-5769)
- Wal-Mart Stores East, LP (Vision Center 30-0604)
- Wal-Mart Stores East, LP (Vision Center 30-2534)
- Anna Lee Walding, M.D.
- Jeffery L Walding, MD
- Kristin Danielle Walding, BC-HIS
- Walgreen Co (Walgreens #18103)
- Walgreen Co (Walgreens #19058)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.