Individual provider Active NPI

Amanda Lea Hamilton, LPC

  • Professional Counselor
  • Jonesboro, AR
National Provider Identifier
1679724504
Registry record updated May 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
P1503022 Issued in AR
Practice address
1815 Pleasant Grove Rd
Jonesboro, AR 72401-7870
Phone
(870) 933-6886
Fax
(870) 933-9395
NPI assigned
Oct 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X P1503022 AR Primary

Addresses

Primary practice location

1815 Pleasant Grove Rd
Jonesboro, AR 72401-7870

Mailing address

1815 Pleasant Grove Rd
Jonesboro, AR 72401-7870
Phone (870) 933-6886

Other identifiers 1

IdentifierTypeStateIssuer
182275795MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20241205000014 AR Practitioner - Mental Health Counselor 9739578915 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renew Mental Health and Wellness LLCGroup PAC ID 0345574737, 24 clinicians

Practice addresses (Care Compare)

1150 E Matthews Ave
Suite 101a
Jonesboro, AR 72401-4356
Phone (870) 243-0424

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Renew Mental Health and Wellness, LLC CurrentSince Nov 18, 2024 Accepting new patients
Renew Mental Health and Wellness LLC CurrentSince Nov 18, 2024 Accepting new patients
NC Counseling Services, PLLC CurrentSince Aug 28, 2019 Accepting new patients

Locations

1150 E Matthews Ave
Ste 101A
Jonesboro, AR 72401
Phone (870) 243-0424

Organizations & group practices 3

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": "1223510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525910400000",
    "number": "1679724504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 PLEASANT GROVE RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724017870",
            "telephone_number": "870-933-6886",
            "fax_number": "870-933-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 PLEASANT GROVE RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724017870",
            "telephone_number": "870-933-6886",
            "fax_number": "870-933-9395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "AMANDA",
        "middle_name": "LEA",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-09",
        "last_updated": "2018-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P1503022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182275795",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.