Amy Beitia, LCSW
Individual provider Active NPI Clinical Social Worker · Fruitland, ID
NPI 1104223080 · NPPES record last updated Aug 24, 2022
Key facts
- NPI
- 1104223080
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LCSW-38281 (ID)
- Practice address
- 320 Magnolia Ave
Fruitland, ID 83619-5080 - Phone
- (208) 250-7059
- NPI assigned
- Nov 20, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190401001881 | ID | Practitioner - Clinical Social Worker | 3870833494 | Practice locations: Fruitland, ID |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW-38281 | ID | MD | Clinical Social Worker |
| L7925 | OR | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amy Beitia Counseling and Consultation LLC | Mental Health | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | L7925 | OR | |
| Clinical Social Worker | 1041C0700X | LCSW-38281 | ID | Yes |
Addresses
Primary practice location
320 Magnolia Ave
Fruitland, ID 83619-5080
Mailing address
320 Magnolia Ave
Fruitland, ID 83619-5080
Phone (208) 250-7059
Other providers in Fruitland, ID
- Roman J Babij
- Clinton W Baker
- Leaanna Baker
- Donna Viola Batt
- Michael Baumgarten
- Sage Michele Benintendi-Stringer
- Christina Heninger Benson
- Matthew Joseph Berria
- Cami Lynn Blackburn
- Bluebird Support Services LLC
All providers in Fruitland, ID · Clinical Social Worker in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.