Amanda Leigh McCarthy, MOTR/L

Primary specialty

Mental Health Occupational TherapistTaxonomy code 225XM0800X

License

104602 Issued in MN

Practice address

5842 Hobe LN
White Bear Lake, MN 55110-6477

Phone

(651) 383-1197

NPI assigned

Apr 8, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1523145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1689171522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2563 SUMAC CIR",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551105622",
            "telephone_number": "612-802-2415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5842 HOBE LN",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551106477",
            "telephone_number": "651-383-1197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "AMANDA",
        "middle_name": "LEIGH",
        "credential": "MOTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-08",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XM0800X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Mental Health",
            "state": "MN",
            "license": "104602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609320605",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVOLVE WELL OCCUPATIONAL THERAPY",
            "identifier": "1609320605",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mia Rose Massaro
• Matthew Anderson, M.D. Obstetrics and Gynecology, P.a.
• Lori Matthews, NCTMB
• Zachary May
• Cherida Irene McCall, CNM
• Shannon McCarty, DC
• Anne M McDonald, LICSW
• Sara McGrath-Daly
• Cheryl L McKee, P.A.-C
• Samantha Ann McKinney

• Mental Health Occupational Therapist in White Bear Lake, MN
• Providers in White Bear Lake, MN by specialty
• Mental Health Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.