Individual provider Active NPI

Amanda Shaffer Dobrowolski, M.S., LPC

  • Professional Counselor
  • Allentown, PA
National Provider Identifier
1477977031
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC007430 Issued in PA
Practice address
1011 Brookside Rd Ste 220
Allentown, PA 18106-9025
Phone
(484) 793-2629
NPI assigned
Feb 18, 2014
Last updated
Jan 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC007430 PA Primary

Addresses

Primary practice location

1011 Brookside Rd Ste 220
Allentown, PA 18106-9025

Mailing address

1011 Brookside Rd Ste 220
Allentown, PA 18106-9025
Phone (484) 793-2629

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240417000511 PA Practitioner - Mental Health Counselor 7517306004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1011 Brookside Rd
Suite 220
Allentown, PA 18106-9025
Phone (484) 793-2629

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
PC007430PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Peace of Mind Therapy Professional CurrentSince Jan 16, 2024 Accepting new patients

Locations

1011 Brookside Rd
Ste 220
Allentown, PA 18106
Phone (484) 793-2629

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1392681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1477977031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 BROOKSIDE RD STE 220",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181069025",
            "telephone_number": "484-793-2629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 BROOKSIDE RD STE 220",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181069025",
            "telephone_number": "484-793-2629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBROWOLSKI",
        "first_name": "AMANDA",
        "middle_name": "SHAFFER",
        "credential": "M.S., LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-18",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC007430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.