NPIMap

Organization Active NPI

Amanda L Woollard Ma LPC, LLC

Doing business as Insightful Life Therapy Services

  • Mental Health Counselor
  • Saint Louis, MO
National Provider Identifier
1831873504
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
AMANDA L WOOLLARD MA LPC, LLC
Doing business as
Insightful Life Therapy Services
Practice address
4121 Union Rd Ste 225
Saint Louis, MO 63129-1093
Phone
(314) 730-6787
Fax
(314) 730-6585
NPI assigned
Jun 13, 2023
Last updated
Jun 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Authorized official

Name
Amanda L Woollard, LPCNPI 1972888584
Title
Owner
Phone
(618) 604-8326

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary
Clinical Social Worker 1041C0700X

Addresses

Primary practice location

4121 Union Rd Ste 225
Saint Louis, MO 63129-1093

Mailing address

8539 Talma CT
Affton, MO 63123-3633
Phone (618) 604-8326

Other practice location 1

4121 Union Rd Ste 207
Saint Louis, MO 63129-1070
Phone (314) 730-6787

Other names 1

  • Insightful Life Therapy Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240306001452 MO Part B Supplier - Clinic/Group Practice 5890131437 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Louis, MO
O20251015000836 IL Part B Supplier - Clinic/Group Practice 5890131437 Receives reassigned benefits from 1 practitioner
Practice locations: Collinsville, IL

National Provider Directory

National Provider Directory

Locations

230 Regency Ctr
Collinsville, IL 62234
Phone (314) 730-6787

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1686614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686614400000",
    "number": "1831873504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8539 TALMA CT",
            "city": "AFFTON",
            "state": "MO",
            "postal_code": "631233633",
            "telephone_number": "618-604-8326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 UNION RD STE 225",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631291093",
            "telephone_number": "314-730-6787",
            "fax_number": "314-730-6585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4121 Union Rd Ste 207",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631291070",
            "country_code": "US",
            "telephone_number": "314-730-6787",
            "fax_number": "314-730-6585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AMANDA L WOOLLARD MA LPC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-13",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A",
        "authorized_official_last_name": "WOOLLARD",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-604-8326",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Insightful Life Therapy Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.