AMANDA TANNER (LCMHC) – Mental Health Counselor, NPI 1124417746

AMANDA TANNER (LCMHC) is a healthcare provider. based in Burlington, Vermont. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LCMHC. They hold a License No. 0680105341 (VT). The NPI Number for AMANDA TANNER (LCMHC) is 1124417746

Main info

Female
15 Years Of Experience
Accepts Medicare Assignment
Name
AMANDA TANNER (LCMHC)
NPI
1124417746
Phone
Not provided
Address
208 FLYNN AVE
Enumeration Date
20 January 2015
Last Update Date
29 April 2025

Doctor Profile

Medical School Name
UNIVERSITY OF VERMONT COLLEGE OF MEDICINE
Secondary Phone
8024886000
Graduation Year
2011 (15 years ago)
PAC ID
2062862352
Group Practice PAC ID
3072403831
Professional Enrollment ID
I20231228003314
Address ID
VT054015353BU1138XSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:11State licenses:1Digital endpointsOther names

357 MENTAL HEALTH COUNSELOR in VT

Provider Addresses for AMANDA TANNER (LCMHC)

  • 208 FLYNN AVE

    SUITE 3J

    BURLINGTON, VT 054015429

    Phone:

    Type: Mailing

  • 102 S WINOOSKI AVE

    BURLINGTON, VT 054017406

    Phone: (802) 488-6920

    Fax: (802) 488-6919

    Type: Mailing

  • 1138 PINE ST

    BURLINGTON, VT 054015353

    Phone: (802) 488-6600

    Fax: (802) 488-6919

    Type: Location

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: 2023-12-28

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
I20231228003314IMental Health CounselorVTTBD

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 05401)

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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: 3072403831View full group profile
NameSpecialtyState
-VT
Clinical Social WorkerVT
Clinical Social WorkerVT
-VT
Mental Health CounselorVT
-VT
Mental Health CounselorVT
Nurse PractitionerVT
Nurse PractitionerVT
Clinical Social WorkerVT

Reviews

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Frequently asked questions

Is AMANDA TANNER (LCMHC) listed with a National Provider Identifier?
Yes — AMANDA TANNER (LCMHC) has NPI 1124417746 on file in the registry.
Is AMANDA TANNER (LCMHC) still an active registrant?
AMANDA TANNER (LCMHC) carries an active NPI according to the public dataset.
What kind of doctor is AMANDA TANNER (LCMHC)?
AMANDA TANNER (LCMHC) is associated with Mental Health Counselor in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with AMANDA TANNER (LCMHC)?
Directory geography for AMANDA TANNER (LCMHC) centers on Burlington, Vermont.
When was this NPI issued?
Enumeration for AMANDA TANNER (LCMHC) is noted as January 20, 2015 where the registry provides it.

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