Amanda Tadlock, ED.S., M.A.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0701005494 Issued in VA

Practice address

3965 Fish Hatchery Rd
Gaston, SC 29053-9038

Phone

(803) 755-2261

NPI assigned

Nov 25, 2013

Last updated

Nov 25, 2013By 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 1

Addresses

Other names 1

• Amanda Badger Former name

Medicare fee-for-service enrollment

Enrolled in SC

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 1

Specialty

Mental Health Counselor

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

South Carolina Dept of Mental Health Accounting OfficeGroup PAC ID 9032021175, 226 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• South Carolina Dept of Mental Health Accounting Office

  dba Highway to Hope Tri-County Primary Care

  • Primary Care Nurse Practitioner
  • Bennettsville, SC
  • NPI 1295332690
  Medicare reassignment Care Compare group NPD
• South Carolina Dept of Mental Health Accounting Office

  dba Midlands Crisis Stabilization Center

  • Community/Behavioral Health Agency
  • Columbia, SC
  • NPI 1083421994
  NPD
• South Carolina Dept of Mental Health Accounting Office

  dba Lexington Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lexington, SC
  • NPI 1841374972
  NPD

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

{
    "created_epoch": "1385337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385337600000",
    "number": "1659701829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 PALMETTO PARK BLVD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290727872",
            "telephone_number": "803-996-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3965 FISH HATCHERY RD",
            "city": "GASTON",
            "state": "SC",
            "postal_code": "290539038",
            "telephone_number": "803-755-2261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TADLOCK",
        "first_name": "AMANDA",
        "credential": "ED.S., M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-25",
        "last_updated": "2013-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701005494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "BADGER",
            "credential": "ED.S., M.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Mental Health Counselor in Gaston, SC
• Providers in Gaston, SC by specialty
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2013; 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.