Amanda Louise Tackett

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CDCA.181997 Issued in OH

Practice address

4324 Old Scioto TRL
Portsmouth, OH 45662-6667

Phone

(800) 321-8293

NPI assigned

Jul 29, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: amanda.tackett.p1@direct.thecounselingcenter.nextgenshare.com

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.

• Shawnee Counseling Center LLC

  • Substance Abuse Rehabilitation Facility
  • Portsmouth, OH
  • NPI 1033695051
  NPD (past)
• Shawnee Counseling Center LLC

  • Community/Behavioral Health Agency
  • Portsmouth, OH
  • NPI 1780278705
  NPD (past)

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

{
    "created_epoch": "1595980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1760091425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 132",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457010132",
            "telephone_number": "800-321-8293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4324 OLD SCIOTO TRL",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456626667",
            "telephone_number": "800-321-8293"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "411 Court St",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "OH",
            "postal_code": "456623932",
            "country_code": "US",
            "telephone_number": "740-354-6685",
            "fax_number": "740-876-4005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "AMANDA",
        "middle_name": "LOUISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-29",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.181997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0462391",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lance Blaine Sydnor
• George Beatty Syroney, LPC
• Jaclyn Syroney
• Lori Syroney
• Alivia Raye Tackett, APRN
• Kayla Arlene Tackett
• Tobi Samuel Taiwo, MD
• Theodore Tamen Tanke, MD
• Tanner Seago, DMD, LLC
• Braden Montgomery Tarr

• Addiction (Substance Use Disorder) Counselor in Portsmouth, OH
• Providers in Portsmouth, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2026; 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.