Amanda Gail Conerly, MS, MSCE, LPC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

907 Carter Ave Ste 3
Philadelphia, MS 39350-3645

Phone

(601) 663-2288

Fax

(601) 429-9281

NPI assigned

Dec 4, 2007

Last updated

Apr 7, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Manda Gail Conerly Professional name

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Mental Health Counselor

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Shouted Silence Services, LLC

  dba The Anchor Clinic

  • Mental Health Counselor
  • Philadelphia, MS
  • NPI 1922513761
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1770765471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1111",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393501111",
            "telephone_number": "601-650-8150",
            "fax_number": "601-429-9281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 CARTER AVE STE 3",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393503645",
            "telephone_number": "601-663-2288",
            "fax_number": "601-429-9281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONERLY",
        "first_name": "AMANDA",
        "middle_name": "GAIL",
        "credential": "MS, MSCE, LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-04",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANDA",
            "last_name": "CONERLY",
            "middle_name": "GAIL",
            "credential": "MS, MSCE, LPC, NCC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Melissa Gray Clark, R. P. T.
• Jordan Clearman
• Paula Clearman, F.N.P.
• Julie Holley Coleman, RN
• Kathryn Comans, DPT
• Jason Brian Copeland, FNP-C
• Lindsey Cosgrove, LCSW
• Covenant Palliative and Hospice, LLC
• Cumberland Chiropractic Clinic
• Sarah Kathryn Cummings, OTR/L

• Mental Health Counselor in Philadelphia, MS
• Providers in Philadelphia, MS by specialty
• Mental Health Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.