Active NPI
Amanda Prendergast
- Social Worker
- Philadelphia, PA
National Provider Identifier
1174990154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- SW131567
- Practice address
- 1420 Walnut St Ste 802
Philadelphia, PA 19102-4008 - Phone
- (610) 544-2110
- NPI assigned
- Aug 26, 2015
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | SW131567 | PA | Primary |
Addresses
Primary practice location
1420 Walnut St Ste 802
Philadelphia, PA 19102-4008
Mailing address
1420 Walnut St Ste 802
Philadelphia, PA 19102-4008
Phone (610) 540-2110
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 |
|---|---|---|---|
| SW131567 | PA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662508800000",
"number": "1174990154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1420 WALNUT ST STE 802",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191024008",
"telephone_number": "610-540-2110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1420 WALNUT ST STE 802",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191024008",
"telephone_number": "610-544-2110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRENDERGAST",
"first_name": "AMANDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-26",
"last_updated": "2022-09-07",
"certification_date": "2022-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "PA",
"license": "SW131567",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.