Amanda Colleen Roth

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC-2124 Issued in WY

Practice address

956 12TH St
Cody, WY 82414-3602

Phone

(307) 751-5111

Fax

(307) 587-4014

NPI assigned

Jan 8, 2020

Last updated

Jan 21, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WY

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

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Amanda Roth, LLC

  • Mental Health Counselor
  • Cody, WY
  • NPI 1295448256
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1578441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674259200000",
    "number": "1861032724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 34TH ST",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824149271",
            "telephone_number": "307-751-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "956 12TH ST",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824143602",
            "telephone_number": "307-751-5111",
            "fax_number": "307-587-4014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2538 Big Horn Ave",
            "address_purpose": "LOCATION",
            "city": "Cody",
            "state": "WY",
            "postal_code": "824149299",
            "country_code": "US",
            "telephone_number": "307-587-2197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTH",
        "first_name": "AMANDA",
        "middle_name": "COLLEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-08",
        "last_updated": "2023-01-21",
        "certification_date": "2023-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WY",
            "license": "LPC-2124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Jordan Rolin, LMFT
• Megan Elaina Rose
• Lachelle M Rosenbaum, MSW
• Janet L Rosenberg, LMFT
• Christa Erin Rossi, PPC
• Michael Rudisill
• Darren Jan Ruesch, DDS
• Springer Todd Rush Jr.
• Amy Ruskowsky
• Davis Russell

• Professional Counselor in Cody, WY
• Providers in Cody, WY by specialty
• Professional Counselor in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.