Individual provider Active NPI

Amy Fossett Syen, LCSW

  • Clinical Social Worker
  • Olympia, WA
National Provider Identifier
1043759889
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SWI.LW.70047024 Issued in WA
Practice address
500 Columbia St NW Ste 102
Olympia, WA 98501-4447
Phone
(859) 421-1164
NPI assigned
Feb 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW005357 GA
Clinical Social Worker 1041C0700X SWI.LW.70047024 WA Primary

Addresses

Primary practice location

500 Columbia St NW Ste 102
Olympia, WA 98501-4447

Mailing address

500 Columbia St NW Ste 102
Olympia, WA 98501-4447
Phone (859) 421-1164

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230323001262 GA Practitioner - Clinical Social Worker 6608240155 Reassigns benefits to 1 organization
I20260612003445 WA Practitioner - Clinical Social Worker 6608240155

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Personal Recovery Network LLCGroup PAC ID 5092611384, 612 clinicians

Practice addresses (Care Compare)

160 Clairemont Ave
Suite 400
Decatur, GA 30030-2546
Phone (404) 500-4266

250 Corporate Ctr CT
Stockbridge, GA 30281-6388
Phone (770) 954-8685

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW005357GAMDClinical Social Worker
SWI.LW.70047024WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Recovery Network LLC CurrentSince Apr 10, 2023 Accepting new patients
Ascensa Health, Inc. Past Accepting new patients

Locations

3300 Old Milton Pkwy
Ste 175
Alpharetta, GA 30005
Phone (470) 568-2010

160 Clairemont Ave
Ste 445
Decatur, GA 30030
Phone 4045004266 ext. 121

160 Clairemont Ave
Ste 400
Decatur, GA 30030
Phone (404) 500-4266

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/stjudesrecovery/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1043759889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 COLUMBIA ST NW STE 102",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985014447",
            "telephone_number": "859-421-1164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 COLUMBIA ST NW STE 102",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985014447",
            "telephone_number": "859-421-1164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYEN",
        "first_name": "AMY",
        "middle_name": "FOSSETT",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-13",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005357",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SWI.LW.70047024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.