Amanda Jean Mullery, NCC, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC014279 Issued in PA

Practice address

357 S Gulph Rd Ste 260
King of Prussia, PA 19406-3739

Phone

(610) 892-3800

NPI assigned

Mar 9, 2022

Last updated

Nov 2, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Delaware County Professional Services, IncGroup PAC ID 2668436692, 276 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Delaware County Professional Services, Inc

  dba LifeStance

  • Psychiatry Physician
  • Media, PA
  • NPI 1952485864
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1646784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730505600000",
    "number": "1437806320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "357 S GULPH RD STE 260",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063739",
            "telephone_number": "610-892-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357 S GULPH RD STE 260",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063739",
            "telephone_number": "610-892-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLERY",
        "first_name": "AMANDA",
        "middle_name": "JEAN",
        "credential": "NCC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-09",
        "last_updated": "2024-11-02",
        "certification_date": "2024-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC014279",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC014279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew M Moschitta, O.D.
• Holly Moyer, BCBA
• Monique Mudryy, PSYD
• Corbin Earl Muetterties, M.D.
• Ellen Mullarkey
• Brittany Mumin
• Amanda Mummery
• Sarah Munson, BCBA
• Danielle Murphy
• Meredith Gayle Murphy, LICAC

• Professional Counselor in King of Prussia, PA
• Providers in King of Prussia, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2024; 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.