Marisa Brooke Ament – Social Worker

Key facts

NPI: 1083197255
Entity type: Individual (NPI type 1)
Primary specialty: Social Worker 104100000X
Practice address: 1883 Wisconsin Ave
Palm Harbor, FL 34683-4721
Phone: (717) 869-2913
NPI assigned: Sep 12, 2018
Sex: Female
Sole proprietor: Yes

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Developmental Therapist	222Q00000X
Social Worker	104100000X			Yes

Addresses

Primary practice location

1883 Wisconsin Ave
Palm Harbor, FL 34683-4721

Mailing address

1883 Wisconsin Ave
Palm Harbor, FL 34683-4721
Phone (717) 869-2913

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 19, 2021.

{
    "created_epoch": "1536710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1083197255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1883 WISCONSIN AVE",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346834721",
            "telephone_number": "717-869-2913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1883 WISCONSIN AVE",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346834721",
            "telephone_number": "717-869-2913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMENT",
        "first_name": "MARISA",
        "middle_name": "BROOKE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-12",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

All providers in Palm Harbor, FL · Social Worker in Florida

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 19, 2021. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.