Individual provider Active NPI

Amanda Pietig, LMFT

  • Marriage & Family Therapist
  • West Des Moines, IA
National Provider Identifier
1902407778
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
091628 Issued in IA
Practice address
6600 Westown Pkwy Ste 240
West Des Moines, IA 50266-7714
Phone
(515) 203-4093
NPI assigned
Nov 6, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 091628 IA Primary

Addresses

Primary practice location

6600 Westown Pkwy Ste 240
West Des Moines, IA 50266-7714

Mailing address

6600 Westown Pkwy Ste 240
West Des Moines, IA 50266-7714
Phone (515) 203-4093

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
091628IAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1902407778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 WESTOWN PKWY STE 240",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502667714",
            "telephone_number": "515-203-4093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 WESTOWN PKWY STE 240",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502667714",
            "telephone_number": "515-203-4093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIETIG",
        "first_name": "AMANDA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-06",
        "last_updated": "2020-11-06",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IA",
            "license": "091628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

Verify at the official NPI Registry.