Individual provider Active NPI

Amanda Jane Lind, LMSW

  • Mental Health Counselor
  • Albuquerque, NM
National Provider Identifier
1861004822
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
M-11869 Issued in NM
Practice address
2600 Marble Ave NE BLDG 2
Albuquerque, NM 87106-2058
Phone
(505) 272-8190
NPI assigned
Aug 20, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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 M-11869 NM Primary

Addresses

Primary practice location

2600 Marble Ave NE BLDG 2
Albuquerque, NM 87106-2058

Mailing address

808 N 3Rd St
Goshen, IN 46528-7100
Phone (574) 534-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20240918002974 IN Practitioner - Clinical Social Worker 6709327661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maple City Health Care Center IncGroup PAC ID 2163569401, 29 clinicians

Practice addresses (Care Compare)

213 Middlebury St
Goshen, IN 46528-2956
Phone (574) 534-3300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
M-11869NMMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Maple City Health Care Center, Inc CurrentSince Aug 10, 2024 Accepting new patients
Maple City Health Care Center, Inc. CurrentSince Aug 10, 2024 Accepting new patients

Locations

213 Middlebury St
Goshen, IN 46528
Phone (574) 534-0088

808 N 3rd St
Goshen, IN 46528
Phone (574) 534-0088

2606 Peddlers Village Rd
Ste 210
Goshen, IN 46526
Phone (260) 602-3276

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1861004822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 N 3RD ST",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465287100",
            "telephone_number": "574-534-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 MARBLE AVE NE BLDG 2",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062058",
            "telephone_number": "505-272-8190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIND",
        "first_name": "AMANDA",
        "middle_name": "JANE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-20",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "M-11869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.