Individual provider Active NPI

Amanda Lynn Alexander, M.A.

  • Mental Health Counselor
  • Colorado Springs, CO
National Provider Identifier
1841598372
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC.0013788 Issued in CO
Practice address
875 W Moreno Ave
Colorado Springs, CO 80905-1731
Phone
(719) 284-6560
NPI assigned
Mar 8, 2011
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC.0013788 CO Primary

Addresses

Primary practice location

875 W Moreno Ave
Colorado Springs, CO 80905-1731

Mailing address

1505 Moss Rose Ave
Malabar, FL 32950
Phone (321) 525-1865

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231214001866 CO Practitioner - Mental Health Counselor 5698124766 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Diversus Health Inc Multi-Specialty Current Accepting new patients
Diversus Health Inc Multi-Specialty CurrentSince Jan 1, 2024 Accepting new patients

Locations

460 County Road 43
Ste 7
Bailey, CO 80421
Phone (303) 838-5013

328 10th St
Calhan, CO 80808

115 S Parkside Dr
Colorado Springs, CO 80910
Phone (719) 572-6340

179 S Parkside Dr
Colorado Springs, CO 80910
Phone (719) 572-6300

1795 Jet Wing Dr
Colorado Springs, CO 80916
Phone (719) 572-6111

220 Ruskin Dr
Colorado Springs, CO 80910
Phone (719) 572-6150

413 Security Blvd
Colorado Springs, CO 80911

6208 Lehman Dr
Colorado Springs, CO 80918
Phone (303) 730-0205

875 W Moreno Ave
Colorado Springs, CO 80905
Phone (719) 572-6200

18401 Highway 24
Ste 119
Woodland Park, CO 80863

Organizations & group practices 2

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": "1299542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1841598372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 MOSS ROSE AVE",
            "city": "MALABAR",
            "state": "FL",
            "postal_code": "32950",
            "telephone_number": "321-525-1865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 W MORENO AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809051731",
            "telephone_number": "719-284-6560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "AMANDA",
        "middle_name": "LYNN",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPC.0013788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.