Amanda J Smith, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

005398 Issued in CT

Practice address

325 Main St
Portland, CT 06480-1561

Phone

(860) 342-3252

NPI assigned

Jun 9, 2014

Last updated

Aug 23, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Positive Vibes &Safe Spaces Counseling LLC

  • Professional Counselor
  • East Hartford, CT
  • NPI 1982537486
  NPD Authorized official
• Community Health Resources, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Windsor, CT
  • NPI 1215979810
  NPD (past)

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1891108650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 MAIN ST",
            "city": "PORTLAND",
            "state": "CT",
            "postal_code": "064801561",
            "telephone_number": "860-342-3252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 MAIN ST",
            "city": "PORTLAND",
            "state": "CT",
            "postal_code": "064801561",
            "telephone_number": "860-342-3252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AMANDA",
        "middle_name": "J",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-09",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "005398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Elizabeth Schiano Dicola, LCSW
• Gabrielle Elizabeth Schiavone, APRN
• Sigma Behavioral Health PLLC
• Caitlin Silliman, OTR/L
• Ann L Sinko, LMFT
• Michael Andrew Sortito, D.M.D.
• Symmetry Physical Therapy, LLC
• Wendy Ann Tagan Conroy, APRN
• Katherine Tansey, PTA
• Marissa Naomi Taylor, OTR

• Professional Counselor in Portland, CT
• Providers in Portland, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.