MRS. AMANDA RAU MCKENNA – Professional Counselor, NPI 1124756440

MRS. AMANDA RAU MCKENNA is a healthcare provider. based in Old saybrook, Connecticut. specializing in MENTAL HEALTH COUNSELOR. They hold a License No. 005571 (CT). The NPI Number for MRS. AMANDA RAU MCKENNA is 1124756440

Main info

Female
Sole Proprietor
16 Years Of Experience
Accepts Medicare Assignment
Name
MRS. AMANDA RAU MCKENNA
NPI
1124756440
Phone
(860) 209-6165
Address
5 SEABREEZE RD
Enumeration Date
14 August 2022
Last Update Date
14 August 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2037290341
Graduation Year
2010 (16 years ago)
PAC ID
2062864101
Group Practice PAC ID
9638504202
Professional Enrollment ID
I20240115000420
Address ID
CT067704019NA16XXXAVEX300

Contacts

Main Contact
SOAPURL
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness85
Years active:3State licenses:1Other namesUpdated within 12 months

818 MENTAL HEALTH COUNSELOR in CT

Provider Addresses for MRS. AMANDA RAU MCKENNA

  • 5 SEABREEZE RD

    OLD SAYBROOK, CT 064752723

    Phone: (860) 209-6165

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-01-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240115000420IMental Health CounselorCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06475)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9638504202View full group profile
NameSpecialtyState
Clinical Social WorkerCT
Mental Health CounselorCT
Clinical Social WorkerCT
Clinical Social WorkerCT
Mental Health CounselorOR
Marriage And Family TherapistCT
Mental Health CounselorKY
Clinical Social WorkerCT
Clinical Social WorkerCT
Clinical Social WorkerCT

Reviews

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Frequently asked questions

What number should I use to identify MRS. AMANDA RAU MCKENNA for billing?
Administrative and clinical systems typically use NPI 1124756440 for MRS. AMANDA RAU MCKENNA.
Is MRS. AMANDA RAU MCKENNA currently accepting referrals based on NPI status?
Registry metadata lists MRS. AMANDA RAU MCKENNA as active.
What type of care does MRS. AMANDA RAU MCKENNA provide?
MRS. AMANDA RAU MCKENNA's profile centers on Professional Counselor. Clinical services aligned with this taxonomy classification.
What geographic area is tied to MRS. AMANDA RAU MCKENNA?
MRS. AMANDA RAU MCKENNA is associated with Old Saybrook, Connecticut in the same public data insurers reference.
Can I export MRS. AMANDA RAU MCKENNA's record?
You can download the official NPPES record; we summarize key fields for readability.

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