Individual provider Active NPI

Amanda H Nelson

  • Mental Health Counselor
  • St George, UT
National Provider Identifier
1972770568
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
8400126-6004 Issued in UT
Practice address
474 W 200 N
St George, UT 84770-4505
Phone
(435) 634-5600
Fax
(435) 634-8700
NPI assigned
May 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 8400126-6004 UT Primary
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

474 W 200 N
St George, UT 84770-4505

Mailing address

474 W 200 N
Ste#300
St George, UT 84770-4505
Phone (435) 634-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20250103001543 UT Practitioner - Mental Health Counselor 0648708651 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8400126-6004UTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Center Current Accepting new patients
Southwest Center CurrentSince Oct 28, 2024 Accepting new patients

Locations

474 W 200 N
#300
St George, UT 84770
Phone (435) 634-5621

474 W 200 N
Ste 300
St George, UT 84770
Phone (435) 634-5606

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 and National Provider Directory roles.

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Center 18 clinicians

Practice addresses (Care Compare)

474 W 200
Suite 300
Saint George, UT 84770-4505

474 W 200 N
300 Southwest Center/Southwest Behavioral H
St George, UT 84770-4505
Phone (435) 634-5600

NPI Registry JSON

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1972770568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "474 W 200 N",
            "address_2": "STE#300",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847704505",
            "telephone_number": "435-634-5600",
            "fax_number": "435-986-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "474 W 200 N",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847704505",
            "telephone_number": "435-634-5600",
            "fax_number": "435-634-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "AMANDA",
        "middle_name": "H",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-13",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "8400126-6004",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.