Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Amanda Colleen Roth

Individual provider Professional Counselor · NPI 1861032724

Amanda Colleen Roth is a Mental Health Counselor in Cody, Wyoming. Qualified in 2019, 7 years ago. Practices as a sole proprietor, works from 2 locations and accepts Medicare assignment. Licensed in Wyoming.

Years since qualifying
7
Licensed in
WY
In the registry since
2020
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Practice location Address checks out

956 12th St
Cody, WY 82414-3602
Phone: (307) 751-5111
Fax: (307) 587-4014
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2538 Big Horn Ave, Cody, WY 82414-9299 — (307) 587-2197

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence LPC-2124 (WY)

Record details

NPI number1861032724
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 8, 2020
Last updated in NPPESJanuary 21, 2023
Certification dateJanuary 21, 2023
Mailing address326 34th St, Cody, WY 82414-9271

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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