Amanda Gilliam
Individual provider Active NPI Peer Specialist · South Shore, KY
NPI 1912611468 · NPPES record last updated Jun 10, 2025
Key facts
- NPI
- 1912611468
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- License
- 299658 (KY)
- Practice address
- 472 Main St
South Shore, KY 41175-9558 - Phone
- (866) 233-1955
- NPI assigned
- Jan 10, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 299658 | KY | MD | Peer Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 299658 | KY | Yes |
Addresses
Primary practice location
472 Main St
South Shore, KY 41175-9558
Mailing address
PO Box 790
Ashland, KY 41105-0790
Phone (606) 329-8588
Other providers in South Shore, KY
- Kaylee Flannery
- Rose Francis
- Sharon Megan Fulton
- Lisa Carol Garrison
- Giggles & Gab Speech Therapy
- Dorothy Luanne Gravely
- Greenup County Health Department
- Greenup County Health Dept
- Gregory Hudson MD Inc
- Rachel M Hall
All providers in South Shore, KY · Peer Specialist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.