Individual provider Active NPI

Amanda Doughty, MA

  • Mental Health Counselor
  • Omak, WA
National Provider Identifier
1740704642
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH61022940 Issued in WA
Practice address
1007 Koala Dr
Omak, WA 98841-9247
Phone
(509) 826-6191
Fax
(509) 826-3029
NPI assigned
Aug 1, 2017
Last updated
Feb 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH61022940 WA Primary

Addresses

Primary practice location

1007 Koala Dr
Omak, WA 98841-9247

Mailing address

1007 Koala Dr
Omak, WA 98841-9247
Phone (509) 826-6191

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240418000962 WA Practitioner - Mental Health Counselor 4587003983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Okanogan Behavioral HealthcareGroup PAC ID 6204828320, 11 clinicians

Practice addresses (Care Compare)

1007 Koala Dr
Omak, WA 98841-9247
Phone (509) 826-6191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Mindcare Solutions of Texas PA CurrentSince Jul 24, 2022 Accepting new patients
Okanogan Behavioral Healthcare Mental Health CurrentSince Feb 25, 2024 Accepting new patients

Locations

1007 Koala Dr
Omak, WA 98841
Phone (509) 826-8409

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1740704642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 KOALA DR",
            "city": "OMAK",
            "state": "WA",
            "postal_code": "988419247",
            "telephone_number": "509-826-6191",
            "fax_number": "509-826-3029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 KOALA DR",
            "city": "OMAK",
            "state": "WA",
            "postal_code": "988419247",
            "telephone_number": "509-826-6191",
            "fax_number": "509-826-3029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHTY",
        "first_name": "AMANDA",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-01",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61022940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omak, WA

Sources for this page

Verify at the official NPI Registry.