Amanda Elliott, MA, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

XL5368 Issued in ME

Practice address

52 Christian Ridge Rd
Ellsworth, ME 04605-3210

Phone

(207) 667-5357

NPI assigned

Oct 9, 2019

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 1

Medicare fee-for-service enrollment

Enrolled in ME

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Community Health and Counseling Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bangor, ME
  • NPI 1457415184

  ME

  Medicare reassignment NPD
• Community Health and Counseling Services

  • Community Based Hospice Care Agency
  • Bangor, ME
  • NPI 1508921842
  NPD

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

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1750923975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 CHRISTIAN RIDGE RD",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046053210",
            "telephone_number": "207-610-9244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 CHRISTIAN RIDGE RD",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046053210",
            "telephone_number": "207-667-5357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "AMANDA",
        "credential": "MA, LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-09",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": "XL5368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MAINE",
            "identifier": "CC6953",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eastern Maine Homecare
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• Jessie Daley Eklund, FNP-C
• Elevate Dental Extractions
• Elias & Keteyian
• Lea Elliott, L.AC.
• Ellsworth Bucksport Dental Associates
• Ellsworth Chiropractic, PA
• Ellsworth Uveitis & Retina Care, PA
• Emergency Medicine Services of Maine, LLC

• All providers in Ellsworth, ME
• Mental Health Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; 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.