Amanda Everly, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH60307682 Issued in WA

Practice address

304 Main Ave S Ste 102
Renton, WA 98057-2758

Phone

(206) 518-1340

Fax

(855) 958-5396

NPI assigned

Nov 29, 2012

Last updated

Aug 2, 2024By 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

Medicare fee-for-service enrollment

Enrolled in WA

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, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Freed Spirit Studios

  • Mental Health Counselor
  • Renton, WA
  • NPI 1508377805
  NPD Authorized official

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

{
    "created_epoch": "1354147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1700121902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 MAIN AVE S STE 102",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572758",
            "telephone_number": "206-518-1340",
            "fax_number": "855-958-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 MAIN AVE S STE 102",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572758",
            "telephone_number": "206-518-1340",
            "fax_number": "855-958-5396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERLY",
        "first_name": "AMANDA",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-29",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60307682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evercare Healths LLC
• Evergreen at Talbot Road, L.L.C. (Talbot Center for Rehabilitation and Healthcare)
• Evergreen Pediatric Nutrition LLC
• Evergreen Treatment Services
• Everlasting Smiles 4 U
• Martha Ewer
• Express Care TX PLLC
• Sierra Lynn Ezrre
• F.R. Dahm DDS PLLC
• James Robert Fackelman, MD

• Mental Health Counselor in Renton, WA
• Providers in Renton, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.