Amanda Lynch, M.A., CM-A, BHRS
Individual provider Active NPI Mental Health Counselor · McLoud, OK
NPI 1528078946 · NPPES record last updated Mar 4, 2024
Key facts
- NPI
- 1528078946
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 105365 S Highway 102
McLoud, OK 74851-3051 - Phone
- (405) 964-2081
- NPI assigned
- Aug 8, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231227003408 | OK | Order and Referring Only - Mental Health Counselor | 6901256312 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Medical Assistant, Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 390200000X-HEALTH CA | OK | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kickapoo Tribal Health Center | Past | Accepting new patients | |
| Kickapoo Tribal Health Center | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 390200000X-HEALTH CA | OK | |
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
105365 S Highway 102
McLoud, OK 74851-3051
Mailing address
628 W Central
Carney, OK 74832-9629
Phone (405) 865-2059
Other practice location 1
112 McKinley Ave
1605 East First Street
Chandler, OK 74834-1622
Phone (405) 258-3040 ext. 554
Other providers in McLoud, OK
- Tiara Donn McKensie Kruta
- Garrett William Lafleur
- Lisa A Lauderdale
- Megan Buckner Ledford
- Chandra Lone Wolf
- Carrie McCoy
- Evelyn Angie McElrath I
- Deaglan Dan'El McGowan
- MCL Nursing, LLC
- Victoria Lynn McLearen
All providers in McLoud, OK · Mental Health Counselor in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.