Amanda Mary Kampa, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

17203 Issued in MN

Practice address

823 Maple St
Brainerd, MN 56401-3770

Phone

(218) 454-3826

Fax

(218) 454-1024

NPI assigned

Dec 2, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Northern Pines Mental Health Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Little Falls, MN
  • NPI 1013904051
  NPD
• Northern Pines Mental Health Center, Inc.

  • Community/Behavioral Health Agency
  • Brainerd, MN
  • NPI 1225168602
  NPD (past)

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

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1043857774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 367",
            "city": "LITTLE FALLS",
            "state": "MN",
            "postal_code": "563450367",
            "telephone_number": "320-632-6647",
            "fax_number": "320-639-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 MAPLE ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013770",
            "telephone_number": "218-454-3826",
            "fax_number": "218-454-1024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMPA",
        "first_name": "AMANDA",
        "middle_name": "MARY",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-02",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "17203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynne Ellen Johnson, MS LP
• Scott A Joing, M.D.
• Alexandra A Jones, LAT, ATC
• Kaitlyn Jones, PTA
• Laura A Joque, MD
• Louis Kappes
• Tiffany B Keehr, MSW, LICSW
• Roland Edward Kehr Jr., D.D.S.
• Linda M Kelley, CNP, PMHNP, B.C.
• Megan Nicole Marlatt Kempf, PA

• Clinical Social Worker in Brainerd, MN
• Providers in Brainerd, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.