Amanda Edwards, LPC-S

Primary specialty

CounselorTaxonomy code 101Y00000X

License

7223 Issued in OK

Practice address

310 Rubber Rd
Tahlequah, OK 74464-2522

Phone

(918) 817-1638

NPI assigned

Nov 13, 2014

Last updated

Aug 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Wellness Centers of Oklahoma LLP

  dba Mental Wellness Centers of Oklahoma

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tahlequah, OK
  • NPI 1407516370
  NPD Authorized official

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

{
    "created_epoch": "1415836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1710383013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 N WATER AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744642825",
            "telephone_number": "918-817-1638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 RUBBER RD",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744642522",
            "telephone_number": "918-817-1638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "AMANDA",
        "credential": "LPC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-13",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": "7223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eastern Oklahoma Youth Services, Inc.
• Eaglebear Eastman
• Eastside Clinic
• Echota Behavioral Health Services, LLC (Echota Behavioral Health- Tahlequah)
• Echota Behavioral Health Services, LLC (Echota Behavorial Health- Tahlequah)
• Coy Joe Edwards, M.D.
• Eeg Corporation
• Kathy Marie Elayyan
• Richard L. Eller
• Tamarie Ann Eller, DC

• Counselor in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; 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.