Active NPI
Amanda McDonald, LSW
- Social Worker
- Brick, NJ
National Provider Identifier
1174207351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 44SL06944900
- Practice address
- 74 Brick Blvd
Brick, NJ 08723-7984 - Phone
- (732) 832-3444
- NPI assigned
- Jun 9, 2023
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 44SL06944900 | NJ | Primary |
Addresses
Primary practice location
74 Brick Blvd
Brick, NJ 08723-7984
Mailing address
74 Brick Blvd
Brick, NJ 08723-7984
Phone (732) 832-3444
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0029807 | Medicaid | NJ |
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 |
|---|---|---|---|
| 44SL06944900 | NJ | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Mental & Behavioral Services, Inc | 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.
-
dba Positive Reset Services
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Eatontown, NJ
- NPI 1114599305
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714348800000",
"number": "1174207351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "74 BRICK BLVD",
"city": "BRICK",
"state": "NJ",
"postal_code": "087237984",
"telephone_number": "732-832-3444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "74 BRICK BLVD",
"city": "BRICK",
"state": "NJ",
"postal_code": "087237984",
"telephone_number": "732-832-3444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONALD",
"first_name": "AMANDA",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-09",
"last_updated": "2024-04-29",
"certification_date": "2024-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NJ",
"license": "44SL06944900",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0029807",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brick, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.