Amanda Moore, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

10116 Issued in ID

Practice address

855 N Capital Ave Ste 1
Idaho Falls, ID 83402-3405

Phone

(208) 552-0855

NPI assigned

Jan 12, 2024

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 names 1

• Amanda Moore Sasser Other name

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

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 and National Provider Directory roles.

• High Country Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Idaho Falls, ID
  • NPI 1295379865

  Multi-Specialty

  Medicare reassignment NPD
• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  ID, Professional

  Medicare reassignment NPD
• High Country Behavioral Health

  • Mental Illness Community Based Residential Treatment Facility
  • Douglas, WY
  • NPI 1750113882
  NPD

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

{
    "created_epoch": "1705017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1750152203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2195 LOGAN DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014404",
            "telephone_number": "208-357-8909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 N CAPITAL AVE STE 1",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023405",
            "telephone_number": "208-552-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "AMANDA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-12",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "10116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "SASSER",
            "middle_name": "MOORE",
            "credential": "LPC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Steveb John Moody, LPC
• Adam Moon, BS
• Aimee Moon, M.S., CCC-SLP
• McKenzie J Moon
• Shannon Mooney, BEHAVIOR SPECIALIST
• Heather A Moore, RN
• Jared Lee Moore, PHARMD
• Kailey Lynn Moore
• Megan Marie Moore, CCC-SLP
• Michael Kirk Moore Jr., M.D., P.C.

• Professional Counselor in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Professional Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.