Individual provider Active NPI

Amanda E. Messenger, LICSW

  • Clinical Social Worker
  • Rowlesburg, WV
National Provider Identifier
1174094973
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
DP00943809 Issued in WV
Practice address
83 Poplar St
Rowlesburg, WV 26425-1124
Phone
(304) 454-2421
Fax
(304) 454-9690
NPI assigned
Dec 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X DP00943809 WV Primary

Addresses

Primary practice location

83 Poplar St
Rowlesburg, WV 26425-1124

Mailing address

PO Box 399
Grafton, WV 26354-0399
Phone (304) 265-0312

Other practice location 1

1321 N Mountaineer Hwy
Newburg, WV 26410-8994
Phone (304) 892-2812

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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

Enrollment IDStateProvider typePAC IDDetails
I20190114002395 WV Practitioner - Clinical Social Worker 9830435700 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DP00943809WVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Preston Taylor Community Health Centers, Incorporated Current Accepting new patients
Preston Taylor Community Health Centers, Incorporated Current Accepting new patients
Preston-Taylor Community Health Centers Incorporated CurrentSince Dec 17, 2018 Accepting new patients
Preston Taylor Community Health Centers, Incorporated CurrentSince Dec 17, 2018 Accepting new patients

Locations

25 W Bluemont St
Grafton, WV 26354
Phone (304) 265-0312

1321 N Mountaineer Hwy
Newburg, WV 26410
Phone (304) 892-2812

2060 N Mountaineer Hwy
Newburg, WV 26410
Phone (304) 892-2812

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1544054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1174094973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 399",
            "city": "GRAFTON",
            "state": "WV",
            "postal_code": "263540399",
            "telephone_number": "304-265-0312",
            "fax_number": "304-265-0314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 POPLAR ST",
            "city": "ROWLESBURG",
            "state": "WV",
            "postal_code": "264251124",
            "telephone_number": "304-454-2421",
            "fax_number": "304-454-9690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1321 N Mountaineer Hwy",
            "address_purpose": "LOCATION",
            "city": "Newburg",
            "state": "WV",
            "postal_code": "264108994",
            "country_code": "US",
            "telephone_number": "304-892-2812",
            "fax_number": "304-892-2814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MESSENGER",
        "first_name": "AMANDA",
        "middle_name": "E.",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-06",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "DP00943809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rowlesburg, WV

Sources for this page

Verify at the official NPI Registry.