Amanda Leann Siddons, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10136-C Issued in AR

Practice address

3514 Country Club Ave Ste 5And6
Fort Smith, AR 72903-3300

Phone

(479) 657-6636

NPI assigned

Dec 2, 2021

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 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

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 and National Provider Directory roles.

• Western Arkansas Counseling & Guidance Center, Inc

  dba The Guidance Center

  • Community/Behavioral Health Agency
  • Fort Smith, AR
  • NPI 1326040692
  Medicare reassignment NPD
• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  AR

  Medicare reassignment NPD
• The Guidance Center - Ozark Clinic

  • Community/Behavioral Health Agency
  • Ozark, AR
  • NPI 1144495235
  NPD
• The Guidance Center - Whole Health

  dba The Guidance Center Primary Care

  • Family Medicine Physician
  • Fort Smith, AR
  • NPI 1730787037
  NPD

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

{
    "created_epoch": "1638403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1457019937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6090 E HIGHWAY 10",
            "city": "GREENWOOD",
            "state": "AR",
            "postal_code": "729368510",
            "telephone_number": "479-206-2456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3514 COUNTRY CLUB AVE STE 5AND6",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729033300",
            "telephone_number": "479-657-6636"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3111 S 70th St",
            "address_purpose": "LOCATION",
            "city": "Fort Smith",
            "state": "AR",
            "postal_code": "729035017",
            "country_code": "US",
            "telephone_number": "479-452-6650",
            "fax_number": "479-452-5847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDONS",
        "first_name": "AMANDA",
        "middle_name": "LEANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-02",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "2537-C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "10136-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Short, CCC-SLP
• Donald E Shows, MD
• Jasmine Shrestha
• Anam Siddiqi, M.D.
• Batool Iqtidar Siddiqui, M.D.
• David B Sills, MD
• Danny Silver, MD
• Ansley Simmons
• Joseph Simmons, MHPP
• Manesha Simms, MHPP

• Clinical Social Worker in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.