Active NPI
Amanda Young, LPA, LCAS
- Psychologist
- Wilmington, NC
National Provider Identifier
1982949962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 4380
- Practice address
- 615 Shipyard Blvd
Wilmington, NC 28412-6431 - Phone
- (910) 343-0145
- Fax
- (910) 341-5779
- NPI assigned
- Dec 3, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCAS 20357 | NC | |
| Psychologist | 103T00000X | 4380 | NC | Primary |
Addresses
Primary practice location
615 Shipyard Blvd
Wilmington, NC 28412-6431
Mailing address
615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone (910) 343-0145
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCAS 20357 | NC | MD | Addiction (Substance Use Disorder) Counselor |
| 4380 | NC | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464048000000",
"number": "1982949962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 SHIPYARD BLVD",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284126431",
"telephone_number": "910-343-0145",
"fax_number": "910-790-0187"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 SHIPYARD BLVD",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284126431",
"telephone_number": "910-343-0145",
"fax_number": "910-341-5779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "AMANDA",
"credential": "LPA, LCAS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-03",
"last_updated": "2016-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "LCAS 20357",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NC",
"license": "4380",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
- Kendall Walters Yokubaitis, MD
- James Reidar Yon, M.D.
- Kyler York, L.AC.
- Young Men'S Christian Association of Southeastern North Carolina, Inc.
- Adison Joelle Young
- Ashley Young
- Christopher Colin Young, DPM
- Debra Umhoefer Young, M.ED, LCMHC, CCHT
- Gregory Girard Young, DPM
- Kathleen Marie Young, PHD, MPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.