Individual provider Active NPI

Amy Christine Nunez

  • Clinical Social Worker
  • Lake Mary, FL
National Provider Identifier
1194240960
Registry record updated Mar 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW19002 Issued in FL
Practice address
310 Waymont CT Ste 100
Lake Mary, FL 32746-3475
Phone
(407) 635-1979
NPI assigned
Aug 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2023

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 SW19002 FL Primary

Addresses

Primary practice location

310 Waymont CT Ste 100
Lake Mary, FL 32746-3475

Mailing address

175 Middle St Unit 1201
Lake Mary, FL 32746-3625
Phone (866) 610-0580

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

LicenseStateTypeSpecialty
SW19002FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Mary Counseling CurrentSince Dec 24, 2023 Accepting new patients
LMC Debary LLC PastSince Mar 26, 2023 Accepting new patients

Locations

310 Waymont Ct
Ste 100
Lake Mary, FL 32746
Phone (407) 416-3840

Organizations & group practices 2

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": "1502582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679184000000",
    "number": "1194240960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 MIDDLE ST UNIT 1201",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463625",
            "telephone_number": "866-610-0580",
            "fax_number": "866-610-0580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 WAYMONT CT STE 100",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463475",
            "telephone_number": "407-635-1979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNEZ",
        "first_name": "AMY",
        "middle_name": "CHRISTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-13",
        "last_updated": "2023-03-19",
        "certification_date": "2023-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW19002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.