Individual provider Active NPI

Amanda Leigh Kranich, #IMH-26007

  • Mental Health Counselor
  • Fort Myers, FL
National Provider Identifier
1780429530
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH26007 Issued in FL
Practice address
5280 Summerlin Commons Way Ste 804
Fort Myers, FL 33907-2160
Phone
(239) 297-7099
NPI assigned
Jun 25, 2024
Last updated
Jun 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X IMH26007 FL Primary

Addresses

Primary practice location

5280 Summerlin Commons Way Ste 804
Fort Myers, FL 33907-2160

Mailing address

7164 Kola Ter Apt 32
Fort Myers, FL 33907-7712
Phone (201) 694-0782

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
IMH26007FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Art Therapy Services, LLC PastSince Jun 30, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1719273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1780429530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7164 KOLA TER APT 32",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339077712",
            "telephone_number": "201-694-0782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5280 SUMMERLIN COMMONS WAY STE 804",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339072160",
            "telephone_number": "239-297-7099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRANICH",
        "first_name": "AMANDA",
        "middle_name": "LEIGH",
        "credential": "#IMH-26007",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-25",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH26007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.