Individual provider Active NPI

Amanda Metropolus, LPC

  • Professional Counselor
  • Milwaukee, WI
National Provider Identifier
1669878476
Registry record updated Mar 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7276-125 Issued in WI
Practice address
333 W Brown Deer Rd Unit G-580
Milwaukee, WI 53217-2372
Phone
(970) 409-5600
NPI assigned
Nov 6, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X LPC.0013764 CO
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X CO
Professional Counselor 101YP2500X 7276-125 WI Primary

Addresses

Primary practice location

333 W Brown Deer Rd Unit G-580
Milwaukee, WI 53217-2372

Mailing address

2950 N 86TH St
Milwaukee, WI 53222-4725
Phone (920) 266-3799

Other practice location 1

1290 N Williams St Ste 205
Denver, CO 80218-2657
Phone (240) 480-0152

Other practice location 2

2230 S Kinnickinnic Ave
Milwaukee, WI 53207-1330
Phone (414) 870-8624

Other identifiers 1

IdentifierTypeStateIssuer
1000086739MedicaidWI

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPC.0013764COMDProfessional Counselor
7276-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Brave Embodiment Counseling LLC Professional Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1415232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1669878476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 N 86TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532224725",
            "telephone_number": "920-266-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 W BROWN DEER RD UNIT G-580",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532172372",
            "telephone_number": "970-409-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1290 N Williams St Ste 205",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802182657",
            "country_code": "US",
            "telephone_number": "240-480-0152",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2230 S Kinnickinnic Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532071330",
            "country_code": "US",
            "telephone_number": "414-870-8624",
            "fax_number": "414-486-7777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "METROPOLUS",
        "first_name": "AMANDA",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-06",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0013764",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "7276-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000086739",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; 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.