Individual provider Active NPI

Amanda F McKenzie, M.A.

  • Mental Health Counselor
  • Bloomington, IN
National Provider Identifier
1639578172
Registry record updated Aug 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
817 W 17TH St
#2
Bloomington, IN 47404-3333
Phone
(513) 260-3939
NPI assigned
Aug 21, 2014
Last updated
Aug 23, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

817 W 17TH St
#2
Bloomington, IN 47404-3333

Mailing address

817 W 17TH St
#2
Bloomington, IN 47404-3333
Phone (513) 260-3939

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408752000000",
    "number": "1639578172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 W 17TH ST",
            "address_2": "#2",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474043333",
            "telephone_number": "513-260-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 W 17TH ST",
            "address_2": "#2",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474043333",
            "telephone_number": "513-260-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "AMANDA",
        "middle_name": "F",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-21",
        "last_updated": "2014-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.