Individual provider Active NPI

Amanda P Gorham, LMHC

  • Mental Health Counselor
  • Holyoke, MA
National Provider Identifier
1912147950
Registry record updated Feb 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6317 Issued in MA
Practice address
303 Beech St
Holyoke, MA 01040-3968
Phone
(413) 540-1155
NPI assigned
Mar 4, 2009
Last updated
Feb 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 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 6317 MA Primary

Addresses

Primary practice location

303 Beech St
Holyoke, MA 01040-3968

Mailing address

PO Box 791
Holyoke, MA 01041-0791

Other names 1

  • Amanda Lee Porreco Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20240104001127 MA Practitioner - Mental Health Counselor 9133570104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
River Valley Counseling Center IncGroup PAC ID 4981694999, 57 clinicians

Practice addresses (Care Compare)

303 Beech St
Holyoke, MA 01040-3968
Phone (413) 540-1199

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6317MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
River Valley Counseling Center, Inc CurrentSince Mar 12, 2024 Accepting new patients
River Valley Counseling Center, Inc Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

303 Beech St
Holyoke, MA 01040
Phone (413) 540-1155

319 Beech St
Holyoke, MA 01040
Phone (413) 540-1155

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/rvccinc/r4/

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": "1236124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1912147950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 791",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010410791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 BEECH ST",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010403968",
            "telephone_number": "413-540-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORHAM",
        "first_name": "AMANDA",
        "middle_name": "P",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-04",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "6317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "PORRECO",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Holyoke, MA

Sources for this page

Verify at the official NPI Registry.