Active NPI
Amanda M Gillespie, LISW-S
- Clinical Social Worker
- Lorain, OH
National Provider Identifier
1134478787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I.600782-SUPV
- Practice address
- 1865 N Ridge Rd E
Lorain, OH 44055-3300 - Phone
- (440) 462-1538
- Fax
- (440) 324-0070
- NPI assigned
- Aug 29, 2012
- Sex
- Female
- Sole proprietor
- No
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 | I.600782-SUPV | OH | Primary |
Addresses
Primary practice location
1865 N Ridge Rd E
Lorain, OH 44055-3300
Mailing address
1865 N Ridge Rd E
Lorain, OH 44055-3300
Phone (440) 462-1538
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0268768 | Medicaid | OH |
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 |
|---|---|---|---|
| I.600782-SUPV | OH | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557360000000",
"number": "1134478787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1865 N RIDGE RD E",
"city": "LORAIN",
"state": "OH",
"postal_code": "440553300",
"telephone_number": "440-462-1538",
"fax_number": "440-324-0070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1865 N RIDGE RD E",
"city": "LORAIN",
"state": "OH",
"postal_code": "440553300",
"telephone_number": "440-462-1538",
"fax_number": "440-324-0070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLESPIE",
"first_name": "AMANDA",
"middle_name": "M",
"credential": "LISW-S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-29",
"last_updated": "2019-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "I.600782-SUPV",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0268768",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lorain, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.