Active NPI
Amelia D. Canally, LCSW
- Clinical Social Worker
- Austin, TX
National Provider Identifier
1063505725
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 35123
- Practice address
- 3534 Beecave Rd
Suite #114
Austin, TX 78746 - Phone
- (512) 799-4091
- NPI assigned
- Oct 2, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 35123 | TX | Primary |
Addresses
Primary practice location
3534 Beecave Rd
Suite #114
Austin, TX 78746
Mailing address
2714 Tetner Trail
Austin, TX 78704
Phone (512) 799-4091
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0009KX | Other | TX | BLUE CROSS BLUE SHIELD # |
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 |
|---|---|---|---|
| 35123 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461196800000",
"number": "1063505725",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2714 TETNER TRAIL",
"city": "AUSTIN",
"state": "TX",
"postal_code": "78704",
"telephone_number": "512-799-4091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3534 BEECAVE RD",
"address_2": "SUITE #114",
"city": "AUSTIN",
"state": "TX",
"postal_code": "78746",
"telephone_number": "512-799-4091"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANALLY",
"first_name": "AMELIA",
"middle_name": "D.",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-02",
"last_updated": "2016-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "35123",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD #",
"identifier": "0009KX",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.