Individual provider Active NPI

Amanda E. Passman, LCSW

  • Clinical Social Worker
  • Perth Amboy, NJ
National Provider Identifier
1063625853
Registry record updated Jul 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05302000 Issued in NJ
Practice address
570 Lee St
Perth Amboy, NJ 08861-3053
Phone
(732) 442-1666
NPI assigned
May 8, 2007
Last updated
Jul 31, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC05302000 NJ Primary

Addresses

Primary practice location

570 Lee St
Perth Amboy, NJ 08861-3053

Mailing address

570 Lee St
Perth Amboy, NJ 08861-3053
Phone (732) 442-1666

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC05302000NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280534400000",
    "number": "1063625853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 LEE ST",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613053",
            "telephone_number": "732-442-1666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 LEE ST",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613053",
            "telephone_number": "732-442-1666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASSMAN",
        "first_name": "AMANDA",
        "middle_name": "E.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2010-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05302000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perth Amboy, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2010; 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.