Individual provider Active NPI

Amanda Young, LPC

  • Mental Health Counselor
  • Frisco, TX
National Provider Identifier
1447982301
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
81615 Issued in TX
Practice address
3535 Victory Group Way Ste 500
Frisco, TX 75034-6727
Phone
(469) 287-5502
NPI assigned
Jun 29, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 81615 TX Primary

Addresses

Primary practice location

3535 Victory Group Way Ste 500
Frisco, TX 75034-6727

Mailing address

3535 Victory Group Way Ste 500
Frisco, TX 75034-6727
Phone (469) 287-5502

Other identifiers 1

IdentifierTypeStateIssuer
81615OtherTXLICENSED PROFESSIONAL COUNSELOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 17, 2024 through Jul 17, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
81615TXMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1447982301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 VICTORY GROUP WAY STE 500",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750346727",
            "telephone_number": "469-287-5502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 VICTORY GROUP WAY STE 500",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750346727",
            "telephone_number": "469-287-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "AMANDA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "81615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PROFESSIONAL COUNSELOR",
            "identifier": "81615",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

Verify at the official NPI Registry.