Active NPI
Amanda Klink, LMSW
- Clinical Social Worker
- Ilion, NY
National Provider Identifier
1043780612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 094005-01
- Practice address
- 111 Frederick St
Ilion, NY 13357-2541 - Phone
- (315) 866-4851
- NPI assigned
- Nov 27, 2018
- Last updated
- Sep 19, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 094005-01 | NY | Primary |
Addresses
Primary practice location
111 Frederick St
Ilion, NY 13357-2541
Mailing address
906 Highland Ave
Herkimer, NY 13350
Phone (315) 868-1134
Other practice location 1
1151 Albany St
Utica, NY 13501
Phone (315) 368-6515
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 094005-01 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663545600000",
"number": "1043780612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "906 HIGHLAND AVE",
"city": "HERKIMER",
"state": "NY",
"postal_code": "13350",
"telephone_number": "315-868-1134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 FREDERICK ST",
"city": "ILION",
"state": "NY",
"postal_code": "133572541",
"telephone_number": "315-866-4851"
}
],
"practiceLocations": [
{
"address_1": "1151 Albany St",
"address_purpose": "LOCATION",
"city": "Utica",
"state": "NY",
"postal_code": "13501",
"country_code": "US",
"telephone_number": "315-368-6515",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KLINK",
"first_name": "AMANDA",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-27",
"last_updated": "2022-09-19",
"certification_date": "2022-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "094005-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ilion, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.