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AMANDA DAWN SELF
NPI 1245815109
Intermediate Care Facility, Mental Illness in Tennessee Ridge, TN

Active since March 12, 2021
1330 N MAIN ST, TENNESSEE RIDGE, TN 37178(888) 291-4357 Get Directions Write a Review

NPPES record last updated: March 12, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Amanda Dawn Self NPPES

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

AMANDA DAWN SELF (NPI 1245815109) is an individual intermediate care facility, mental illness provider in Tennessee Ridge, Tennessee and active in the NPI registry since March 2021.

NPPES Registry Identity

NPI1245815109
Entity TypeIndividualFemale
Primary Taxonomy310500000X
Provider Legal NameAMANDA DAWN SELF
Location Address1330 N MAIN STTennessee Ridge, TN 37178-4003
Mailing Address220 Mockingbird StErin, TN 37061-6098
Phone(888) 291-4357
Sole ProprietorYes
Enumeration DateMarch 12, 2021
NPPES CertifiedFebruary 18, 2021
✔ NPI 1245815109 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Mental IllnessNursing & Custodial Care Facilities
Taxonomy Code310500000X
Definition
A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness.
1330 N MAIN ST, Tennessee Ridge, TN 37178
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Other Providers at the Same Location NPPES 20

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

JENNIFER GUY
Counselor
1330 N MAIN ST
TENNESSEE RIDGE, TN 37178
Houston County (931) 721-3313
MRS. JODI L CLARK
Technician (Attendant Care Provider)
1330 N MAIN ST
TENNESSEE RIDGE, TN 37178
Houston County (931) 721-3312
SUZANNA DIANE WRIGHT
Counselor (Mental Health)
1330 N MAIN ST
TENNESSEE RIDGE, TN 37178
Houston County (888) 291-4357
MRS. LOUISE AGNES TURNER
Technician (Attendant Care Provider)
1330 N MAIN ST
TENNESSEE RIDGE, TN 37178
Houston County (931) 721-3312
MARTHA JEANETTE MURRAY
Technician (Attendant Care Provider)
1330 N MAIN ST
TENNESSEE RIDGE, TN 37178
Houston County (931) 721-3312
TERRI LYNN MCMILLAN
Counselor
1330 N MAIN ST
TENNESSEE RIDGE, TN 37178
Houston County (931) 721-3312
SHELBIE BALJIC
Psychologist (Counseling)
1330 N MAIN ST
TENNESSEE RIDGE, TN 37178
Houston County (888) 291-4357
MS. CONNY ARCHAMBAULT
Counselor
1330 N MAIN ST
TENNESSEE RIDGE, TN 37178
Houston County (193) 172-1331

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 Self's NPI number?

The NPI number for Amanda Self is 1245815109. It was assigned to this individual provider in the NPPES registry on March 12, 2021.

Where is Amanda Self located?

Amanda Self practices at 1330 N Main St, Tennessee Ridge, TN 37178. The listed phone number is (888) 291-4357.

What is Amanda Self's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Mental Illness with taxonomy code 310500000X.

When was this NPI record last updated?

The NPPES record for Amanda Self was last updated on March 12, 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.