Amanda Dawn Tebo

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

2305210423 Issued in VA

Practice address

131 King St
Northampton, MA 01060-3234

Phone

(413) 665-8717

Fax

(413) 665-9383

NPI assigned

Jul 6, 2019

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

• Amanda Dawn Drew Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1562371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562371200000",
    "number": "1801458252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 KING ST",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010603234",
            "telephone_number": "413-665-8717",
            "fax_number": "413-665-9383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 KING ST",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010603234",
            "telephone_number": "413-665-8717",
            "fax_number": "413-665-9383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 Strong St",
            "address_purpose": "LOCATION",
            "city": "Easthampton",
            "state": "MA",
            "postal_code": "010272538",
            "country_code": "US",
            "telephone_number": "413-265-4115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3800 Fettler Park Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Dumfries",
            "state": "VA",
            "postal_code": "220252045",
            "country_code": "US",
            "telephone_number": "571-358-9210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEBO",
        "first_name": "AMANDA",
        "middle_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-06",
        "last_updated": "2019-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "VA",
            "license": "2305210423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "DREW",
            "middle_name": "DAWN",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gina A Tartarelli
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• Tate Behavioral LLC
• Lauren Ann Taylor
• Joshua Tecu, LCSW
• Pamela Melissa Tefft, LICWS
• Elizabeth Ashley Temple
• Tender Loving Care Health Care Services, L.L.C
• Steven Tenenbaum, LICSW

• Community Health Worker in Northampton, MA
• Providers in Northampton, MA by specialty
• Community Health Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2019; 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.