Amber Brooke Phillips, LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P019254 Issued in NC

Practice address

4601 Lake Boone TR.
Suite 3a
Raleigh, NC 27607

Phone

(919) 709-7307

NPI assigned

Jan 4, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wakemed

  • Internal Medicine Physician
  • Raleigh, NC
  • NPI 1194907717
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1672790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1013620137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 LOMU RIDGE RD APT 204",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276066375",
            "telephone_number": "336-290-3016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 LAKE BOONE TR.",
            "address_2": "SUITE 3A",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27607",
            "telephone_number": "919-709-7307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "AMBER",
        "middle_name": "BROOKE",
        "credential": "LCSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-04",
        "last_updated": "2023-07-11",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P019254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "082004",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "InSync",
            "affiliation": "N",
            "endpointDescription": "Online program",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Program",
            "address_1": "4805 Green Rd Ste 103",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276162848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Betty Philip
• Obed Jolicoeur Philippe
• Lucia Lily Philips
• Sommer Ebdlahad Philips, M.D.
• Aleah Mary Phillips, LCMHC
• Britnee Phillips
• Cameron Vander Phillips
• Cassandra Phillips, LCMHCA, LCASA
• Chermia Phillips, MS, CCC-SLP
• Chester Phillips, ACUPUNCTURIST

• Clinical Social Worker in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.