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AMANDA ICENOGLE
NPI 1174198808
Behavior Analyst in Dothan, AL

Active since May 25, 2021PECOS Enrolled
2543 ROSS CLARK CIR, DOTHAN, AL 36301(334) 699-4007(334) 699-4014 Get Directions Write a Review

NPPES record last updated: May 25, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Amanda Icenogle NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AMANDA ICENOGLE (NPI 1174198808) is an individual behavior analyst provider in Dothan, Alabama, licensed in (103K00000X) and active in the NPI registry since May 2021. She is enrolled in Medicare PECOS and is a graduate of Other.

NPPES Registry Identity

NPI1174198808
Entity TypeIndividualFemale
Primary Taxonomy103K00000X
Provider Legal NameAMANDA ICENOGLE
Location Address2543 ROSS CLARK CIRDothan, AL 36301-4925
Mailing Address60 County Road 755Enterprise, AL 36330-1553 · (334) 464-0063
Phone(334) 699-4007
Fax(334) 699-4014
Sole ProprietorYes
Medical School CMSOther
Enumeration DateMay 25, 2021
NPPES CertifiedMay 21, 2021
✔ NPI 1174198808 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyBehavior AnalystBehavioral Health & Social Service Providers
Taxonomy Code103K00000X
License✔ Licensed · 103K00000X
Definition
A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.
2543 ROSS CLARK CIR, Dothan, AL 36301
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Other Identifiers 1

Medicaid133086AL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amanda Icenogle is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8729558846
PECOS Enrollment IDI20260529000698
Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALLAY INTEGRATIVE MASSAGE THERAPY CENTER LLC
Massage Therapist
2543 ROSS CLARK CIR, SUITE #4
DOTHAN, AL 36301
Houston County (334) 701-9332
MRS. MELODY THIELMANN RBT
Behavior Analyst
2543 ROSS CLARK CIR
DOTHAN, AL 36301
Houston County (334) 699-4007
TONYANEKA C GRISSETT-GASKINS
Behavior Technician
2543 ROSS CLARK CIR
DOTHAN, AL 36301
Houston County (334) 699-4007
SHARON P STRICKLAND
Behavior Analyst
2543 ROSS CLARK CIR
DOTHAN, AL 36301
Houston County (334) 699-4007
ALISON HUSSEY
Behavior Technician
2543 ROSS CLARK CIR
DOTHAN, AL 36301
Houston County (334) 470-0447
MRS. JANA COOPER LMT
Massage Therapist
2543 ROSS CLARK CIR, SUITE 4
DOTHAN, AL 36301
Houston County (334) 701-9332
MR. BRETT KINSAUL
Behavior Analyst
2543 ROSS CLARK CIR
DOTHAN, AL 36301
Houston County (334) 699-4007
MRS. RACHEL KING POPE
Behavior Analyst
2543 ROSS CLARK CIR
DOTHAN, AL 36301
Houston County (334) 596-0476

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Amanda Icenogle's NPI number?

The NPI number for Amanda Icenogle is 1174198808. It was assigned to this individual provider in the NPPES registry on May 25, 2021.

Where is Amanda Icenogle located?

Amanda Icenogle practices at 2543 Ross Clark Cir, Dothan, AL 36301. The listed phone number is (334) 699-4007.

What is Amanda Icenogle's specialty?

The primary specialty registered for this NPI is Behavior Analyst with taxonomy code 103K00000X.

Is Amanda Icenogle enrolled in Medicare?

Yes. Amanda Icenogle is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Amanda Icenogle was last updated on May 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.