Amanda Lyne Wentworth-Puentes, TMHC
Individual provider Active NPI Mental Health Counselor · Des Moines, IA
NPI 1669715215 · NPPES record last updated Apr 2, 2013
Key facts
- NPI
- 1669715215
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 001580 (IA)
- Practice address
- 3125 Douglas Ave Ste 100
Des Moines, IA 50310-5310 - Phone
- (515) 256-8001
- NPI assigned
- Apr 2, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- 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 |
|---|---|---|---|---|
| I20240313003103 | IA | Practitioner - Mental Health Counselor | 5395181234 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Awp Therapy LLC | Mental Health | Current | Accepting new patients |
| Mind and Spirit Counseling Center | Mental Health | Current |
Accepting new patients |
| Lifeline Resources, LLC | Mental Health | Past | Accepting new patients |
Locations
2323 Grand Ave
Ste 100
Des Moines, IA 50312
Phone (281) 762-0659
8553 Urbandale Ave
Urbandale, IA 50322
Phone (515) 274-4006
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 001580 | IA | Yes |
Addresses
Primary practice location
3125 Douglas Ave Ste 100
Des Moines, IA 50310-5310
Mailing address
3125 Douglas Ave Ste 100
Des Moines, IA 50310-5310
Other names
- Amanda Lyne Wentworth
Other providers in Des Moines, IA
- Wellserve, LC
- Welsh Counseling
- Cassie Welsh
- Carissa Wemmie
- Brooklyn Eileen Wendt
- Kaitlyn Werkmeister
- Kara Werth
- Monica D Wescott
- Wesley at Home LLC
- Wesley at Home, LLC
All providers in Des Moines, IA · Mental Health Counselor in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2013. 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.