Active NPI
Amanda L Kisel, MS, LBS, LSW
- Social Worker
- Waymart, PA
National Provider Identifier
1194412569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- SW141253
- Practice address
- 14 Brookside Rd
Waymart, PA 18472-9353 - Phone
- (570) 540-3957
- NPI assigned
- Apr 18, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | BH005106 | PA | |
| Social Worker | 104100000X | SW141253 | PA | Primary |
Addresses
Primary practice location
14 Brookside Rd
Waymart, PA 18472-9353
Mailing address
14 Brookside Rd
Waymart, PA 18472-9353
Phone (570) 540-3957
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW141253 | PA | MD | Social Worker |
| BH005106 | PA | MD | Community/Behavioral Health Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709251200000",
"number": "1194412569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 BROOKSIDE RD",
"city": "WAYMART",
"state": "PA",
"postal_code": "184729353",
"telephone_number": "570-540-3957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 BROOKSIDE RD",
"city": "WAYMART",
"state": "PA",
"postal_code": "184729353",
"telephone_number": "570-540-3957"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KISEL",
"first_name": "AMANDA",
"middle_name": "L",
"credential": "MS, LBS, LSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-04-18",
"last_updated": "2024-03-01",
"certification_date": "2024-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "PA",
"license": "BH005106",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "PA",
"license": "SW141253",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waymart, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.