Amanda Allison-Pacheco, LCPC
Individual provider Active NPI Professional Counselor · Millersville, MD
NPI 1780109660 · NPPES record last updated Nov 20, 2018
Key facts
- NPI
- 1780109660
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LC9118 (MD)
- Practice address
- 8638 Veterans Hwy Ste 301
Millersville, MD 21108-1422 - Phone
- (443) 445-0053
- NPI assigned
- Aug 11, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Luminis Health Medical Group, LLC
Practice addresses (Care Compare)
175 Harry S Truman Pkwy
Annapolis, MD 21401-7573
Phone (410) 573-9000
8200 Good Luck Rd
Lanham, MD 20706-3511
Phone (301) 623-4350
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MD, DC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251120004549 | MD | Practitioner - Clinical Social Worker | 3375035942 | Reassigns benefits to 1 organization |
| I20251222003420 | DC | Practitioner - Clinical Social Worker | 3375035942 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LGP7429 | MD | MD | Mental Health Counselor |
| LC9118 | MD | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luminis Health Medical Group, LLC | Current |
Accepting new patients | |
| Luminis Health Medical Group, LLC | Current |
Accepting new patients | |
| Luminis Health Medical Group, LLC | Current |
Accepting new patients |
Locations
2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366
175 Harry S Truman Pkwy
Annapolis, MD 21401
Phone (410) 573-9000
4175 N Hanson Ct
Ste 201
Bowie, MD 20716
Phone (443) 481-1199
8200 Good Luck Rd
Lanham, MD 20706
Phone (301) 552-2000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LGP7429 | MD | |
| Professional Counselor | 101YP2500X | LC9118 | MD | Yes |
Addresses
Primary practice location
8638 Veterans Hwy Ste 301
Millersville, MD 21108-1422
Mailing address
10630 Little Patuxent Pkwy Ste 209
Columbia, MD 21044-6278
Phone (443) 445-0053
Other providers in Millersville, MD
- Aging Grace LLC
- Grace Toluwalope Ajisafe
- Gladys N Akanoh
- Abdullah Mohammed Al Sayyab
- All Things New Solution LLC
- Americle Healthcare, Inc.
- Whitney Ames
- Derrick Amuzu
- Christine Anchan
- Kristina Anderson
All providers in Millersville, MD · Professional Counselor in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.