Active NPI
Amanda Morse
- Clinical Social Worker
- Kellogg, ID
National Provider Identifier
1154615169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LMSW 31396
- Practice address
- 14 Emerson LN
Kellogg, ID 83837-2454 - Phone
- (208) 783-0660
- NPI assigned
- Jun 7, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | LMSW 31396 | ID | Primary |
Addresses
Primary practice location
14 Emerson LN
Kellogg, ID 83837-2454
Mailing address
14 Emerson LN
Kellogg, ID 83837-2454
Phone (208) 783-0660
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
| License | State | Type | Specialty |
|---|---|---|---|
| LMSW 31396 | ID | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Own Family Medicine and Wellness LLC Dba Active Family Healthcare | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Coeur D Alene, ID
- NPI 1942116884
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307404800000",
"number": "1154615169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 EMERSON LN",
"city": "KELLOGG",
"state": "ID",
"postal_code": "838372454",
"telephone_number": "208-783-0660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 EMERSON LN",
"city": "KELLOGG",
"state": "ID",
"postal_code": "838372454",
"telephone_number": "208-783-0660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORSE",
"first_name": "AMANDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-07",
"last_updated": "2011-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ID",
"license": "LMSW 31396",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kellogg, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.