Amanda Megan Young Nibber, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC7580 Issued in TN

Practice address

10710 Old Highway 64
Bolivar, TN 38008-3587

Phone

(731) 658-6113

Fax

(731) 658-1597

NPI assigned

Oct 28, 2011

Last updated

Nov 8, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NM, TN2 enrollments

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 2

Specialty

Mental Health Counselor

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mental Health Centers and Clinics of TennesseeGroup PAC ID 3678475621, 13 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.

• Mental Health Centers & Clinics of Tennessee

  dba Quinco Mental Health Center

  • Mental Health Counselor
  • Bolivar, TN
  • NPI 1255442794
  Medicare reassignment Care Compare group NPD
• Behavioral Healthcare Services, Inc.

  dba New Mexico Solutions

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Albuquerque, NM
  • NPI 1730112483
  Medicare reassignment NPD
• Behavioral Healthcare Services, Inc.

  dba New Mexico Solutions

  • Community/Behavioral Health Agency
  • Santa Fe, NM
  • NPI 1255780037
  NPD

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

{
    "created_epoch": "1319760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1508142977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10710 OLD HIGHWAY 64",
            "city": "BOLIVAR",
            "state": "TN",
            "postal_code": "380083587",
            "telephone_number": "731-658-6113",
            "fax_number": "731-658-1597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10710 OLD HIGHWAY 64",
            "city": "BOLIVAR",
            "state": "TN",
            "postal_code": "380083587",
            "telephone_number": "731-658-6113",
            "fax_number": "731-658-1597"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "707 Broadway Blvd NE Ste 500",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871022367",
            "country_code": "US",
            "telephone_number": "505-268-0701",
            "fax_number": "270-689-6677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG NIBBER",
        "first_name": "AMANDA",
        "middle_name": "MEGAN",
        "name_prefix": "Miss",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-28",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "T-0144351",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "LPC7580",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "CCMH0217321",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joselyn Wilson, PSYCHOLOGY
• Mary Wilson
• Thomas Gregory Wilson, DDS
• Sherwin A Yaffe, M.D.
• Yn Pakkala M.D, P.C
• Janet M Young, R.N.
• Mary Young, RN,BSN

• Mental Health Counselor in Bolivar, TN
• Providers in Bolivar, TN by specialty
• Mental Health Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.