Amy Michelle Anderson

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

233 SW Wilson Ave, Ste 201
Bend, OR 97702

Phone

(541) 382-8862

NPI assigned

Oct 15, 2020

Last updated

Oct 15, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Life Works of Central Oregon, LLC

  • Professional Counselor
  • Bend, OR
  • NPI 1225169378
  NPD (past)

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

{
    "created_epoch": "1602720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1629676259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 SW WILSON AVE STE 201",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977022988",
            "telephone_number": "541-382-8862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 SW WILSON AVE, STE 201",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97702",
            "telephone_number": "541-382-8862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "AMY",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-15",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225169378",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHP",
            "identifier": "1225169378",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Bend",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "Bend",
            "address_1": "233 SW Wilson Ave, Ste 201",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "97702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kynlee Anderman
• Tracy Anderman
• Matthew Andermann
• Amy M Andersen
• Miah Andersen
• Bryon Anderson
• Carol J Anderson, LPC
• Daniel Anderson, M.A, LPC INTERN
• Donald Robert Anderson, M.D.
• Emma Susann Anderson, LCSW

• Counselor in Bend, OR
• Providers in Bend, OR by specialty
• Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.