Lady a Wellness LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

LADY A WELLNESS LLC

Practice address

3541 S Lafountain St Ste 4
Kokomo, IN 46902-3804

Phone

(765) 432-3617

NPI assigned

Nov 2, 2026

Last updated

Nov 2, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amanda Roberts, PMHNP

Title

Owner

Phone

(765) 432-3617

Specialties & licenses 1

Addresses

Other names 1

• Lady A. Beauty LLC Former legal business name

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

{
    "created_epoch": "1793577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1793577600000",
    "number": "1578462164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3541 S LAFOUNTAIN ST STE 4",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023804",
            "telephone_number": "765-432-3617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3541 S LAFOUNTAIN ST STE 4",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023804",
            "telephone_number": "765-432-3617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LADY A WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-11-02",
        "last_updated": "2026-11-02",
        "certification_date": "2026-11-02",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-432-3617",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lady A. Beauty LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Kokomo, IN
• Providers in Kokomo, IN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.