Active NPI
Amanda Morgan Weaver, LAC
- Mental Health Counselor
- Bentonville, AR
National Provider Identifier
1811912652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- A0512080
- Practice address
- 2508 SE 20TH St
Bentonville, AR 72712-4008 - Phone
- (479) 750-2020
- Fax
- (479) 845-2111
- NPI assigned
- Jul 13, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | A0512080 | AR | Primary |
Addresses
Primary practice location
2508 SE 20TH St
Bentonville, AR 72712-4008
Mailing address
PO Box 6430
Springdale, AR 72766-6430
Phone (479) 750-2020
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
| License | State | Type | Specialty |
|---|---|---|---|
| A0512080 | AR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811912652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6430",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727666430",
"telephone_number": "479-750-2020",
"fax_number": "479-845-2111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2508 SE 20TH ST",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727124008",
"telephone_number": "479-750-2020",
"fax_number": "479-845-2111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEAVER",
"first_name": "AMANDA",
"middle_name": "MORGAN",
"credential": "LAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AR",
"license": "A0512080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bentonville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.