The Practice of Amanda Keller, LCSW, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

THE PRACTICE OF AMANDA KELLER, LCSW, PLLC

Practice address

5 Southside Dr Ste 11-131
Clifton Park, NY 12065-3870

Phone

(518) 906-9116

NPI assigned

Feb 8, 2022

Last updated

Feb 8, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amanda Keller, LCSW-RNPI 1336481571

Title

Sole Member/Clinician

Phone

(518) 906-9116

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amanda Leigh Keller, LCSW-R

  • Clinical Social Worker
  • Clifton Park, NY
  • NPI 1336481571
  NPD Authorized official

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644278400000",
    "number": "1053065169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SOUTHSIDE DR STE 11-131",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120653870",
            "telephone_number": "518-906-9116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 SOUTHSIDE DR STE 11-131",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120653870",
            "telephone_number": "518-906-9116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PRACTICE OF AMANDA KELLER, LCSW, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-08",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "SOLE MEMBER/CLINICIAN",
        "authorized_official_telephone_number": "518-906-9116",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Clifton Park, NY
• Providers in Clifton Park, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.

Verify at the official NPI Registry.