Active NPI
Amanda Dimartini, MA, LPC
- Professional Counselor
- Springfield, MO
National Provider Identifier
1811288558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2010042210
- Practice address
- 3543 S Lone Pine Ave
Springfield, MO 65804-4854 - Phone
- (417) 379-4781
- NPI assigned
- Apr 28, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2010042210 | MO | Primary |
Addresses
Primary practice location
3543 S Lone Pine Ave
Springfield, MO 65804-4854
Mailing address
3543 S Lone Pine Ave
Springfield, MO 65804-4854
Phone (417) 379-4781
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002283881 | Other | MO | CHILDREN'S TREATMENT SERVICES |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2010042210 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420416000000",
"number": "1811288558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3543 S LONE PINE AVE",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658044854",
"telephone_number": "417-379-4781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3543 S LONE PINE AVE",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658044854",
"telephone_number": "417-379-4781"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIMARTINI",
"first_name": "AMANDA",
"credential": "MA, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-28",
"last_updated": "2015-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2010042210",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHILDREN'S TREATMENT SERVICES",
"identifier": "002283881",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.