Individual provider Active NPI

Amanda Wood, LCSW

  • Clinical Social Worker
  • Punta Gorda, FL
National Provider Identifier
1194248344
Registry record updated Aug 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW14055 Issued in FL
Practice address
1700 Education Ave
Punta Gorda, FL 33950-6222
Phone
(941) 941-8300
Fax
(941) 347-6493
NPI assigned
Jul 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2019

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 SW14055 FL Primary

Addresses

Primary practice location

1700 Education Ave
Punta Gorda, FL 33950-6222

Mailing address

1700 Education Ave
Punta Gorda, FL 33950-6222
Phone (941) 639-8300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170925001051 FL Practitioner - Clinical Social Worker 4284908690 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Charlotte Behavioral Health Care IncGroup PAC ID 4587649918, 10 clinicians

Practice addresses (Care Compare)

1700 Education Ave
Punta Gorda, FL 33950-6222
Phone (941) 639-8300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW14055FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
MCR Health, Inc. CurrentSince Aug 11, 2017 Accepting new patients
MCR Health, Inc. CurrentSince Aug 11, 2017 Accepting new patients

Locations

725 N 12th Ave
Arcadia, FL 34266
Phone (863) 494-1242

700 8th Ave W
Ste 101
Palmetto, FL 34221
Phone (941) 776-4008

12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231

Organizations & group practices 3

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": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1194248344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 EDUCATION AVE",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339506222",
            "telephone_number": "941-639-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 EDUCATION AVE",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339506222",
            "telephone_number": "941-941-8300",
            "fax_number": "941-347-6493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "AMANDA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-19",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Punta Gorda, FL

Sources for this page

Verify at the official NPI Registry.