Amy K Nelson, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

SW11248 Issued in FL

Practice address

621 N Lake Parker Ave
Lakeland, FL 33801-2040

Phone

(863) 519-0575

Fax

(863) 733-4496

NPI assigned

Apr 14, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Amy Erickson Former name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Peace River Center for Personal Development Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bartow, FL
  • NPI 1821097767
  Medicare reassignment
• Peace River Center for Personal Development Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lakeland, FL
  • NPI 1538802939
  NPD
• Peace River Center for Personal Development Inc

  • Psychiatry Physician
  • Lakeland, FL
  • NPI 1114673589
  NPD (past)
• Peace River Center for Personal Development Inc

  • Case Management Agency
  • Lakeland, FL
  • NPI 1265187728
  NPD (past)

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

{
    "created_epoch": "1302739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545782400000",
    "number": "1083904700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "338311559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 N LAKE PARKER AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338012040",
            "telephone_number": "863-519-0575",
            "fax_number": "863-733-4496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "AMY",
        "middle_name": "K",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-14",
        "last_updated": "2018-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "SW11248",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008428900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003556600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "ERICKSON",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hannah Michele Neel
• Kyara Negron-Diaz
• Rosa Enis Negron-Munoz, MD
• Laurie A Neher, APRN
• Anna Mi Neira, CRNA
• D.J. Nelson, APRN
• Jillian A Nelson, M.D.
• Loreana Nelson, FNP
• Shaina Nembhard, CRNA
• Nemours Children'S Health, Lakeland, Specialty Care

• Social Worker in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.