AMANDA NUGENT DIVINE, M.S., LMFT — NPI 1417178195 (Licensed & Credentialed Behavioral Health & Social Service Providers — Marriage and Family Therapist in SACRAMENTO, CA)

CMS-1500 Box 24J / 33a • NPI

1417178195

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

106H00000X (CMS E1)

Licensed & Credentialed Behavioral Health & Social Service Providers — Marriage and Family Therapist

Box 32 Service Location & ZIP+4

3780 ROSIN CT, SUITE 110, SACRAMENTO, CA, 95834-1646

✓ 9-Digit EDI 837 ZIP+4 (95834-1646)

Practice Phone & Referral Fax

(916) 417-7374

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1417178195 (AMANDA NUGENT DIVINE, M.S., LMFT) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1417178195` (NPI-1 Individual Practitioner)
Provider / Legal Name	AMANDA NUGENT DIVINE, M.S., LMFT
Plain-English Specialty	Licensed & Credentialed Behavioral Health & Social Service Providers — Marriage and Family Therapist NUCC Code: `106H00000X` (Marriage & Family Therapist)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	3780 ROSIN CT, SUITE 110, SACRAMENTO, CA, 95834-1646
Practice Telephone / Fax	Tel: (916) 417-7374
Administrative Mailing Address	3533 LAMBETH DR, RESCUE, CA, 95672-9391
Enumeration & Last Sync	Enumerated: 2007-05-01 \| CMS Record Updated: 2012-03-14

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

3780 ROSIN CT, SUITE 110, SACRAMENTO, CA, 95834-1646

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Plain-English Taxonomy & CMS Crosswalk (106H00000X)

What Does Taxonomy Code 106H00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 106H00000X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Marriage and Family Therapist"

CMS-1500 Medicare Specialty Crosswalk: CMS Code E1 (Marriage and Family Therapist)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Marriage & Family Therapist for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (AMANDA NUGENT DIVINE, M.S., LMFT)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`106H00000X` — Marriage & Family Therapist Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Marriage and Family Therapist	State: CA \| License: `46360` \| Primary: Yes (Primary)
`101YP2500X` — Counselor, Professional Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor	State: TX \| License: `67208` \| Primary: Secondary

Medical Billing, RCM & Hospital Credentialing Teams:

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AMANDA NUGENT DIVINE, M.S., LMFT (NPI #1417178195)