Amanda K Ross, LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P016400 Issued in NC

Practice address

2829 Arlington Ave
Fayetteville, NC 28303-5403

Phone

(910) 461-9291

Fax

(910) 676-8009

NPI assigned

Jul 19, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• One Up Services LLC

  • Community/Behavioral Health Agency
  • Shannon, NC
  • NPI 1245919547
  NPD Authorized official
• Creative Minds Healthcare PLLC

  • Community/Behavioral Health Agency
  • Fayetteville, NC
  • NPI 1801526116

  Addiction (Substance Use Disorder)

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1205409380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 N SHANNON RD",
            "city": "SHANNON",
            "state": "NC",
            "postal_code": "283869259",
            "telephone_number": "860-335-9651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2829 ARLINGTON AVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035403",
            "telephone_number": "910-461-9291",
            "fax_number": "910-676-8009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2827 Arlington Ave",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283035403",
            "country_code": "US",
            "telephone_number": "910-676-8019",
            "fax_number": "910-676-8008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "426 Harris Ave",
            "address_purpose": "LOCATION",
            "city": "Raeford",
            "state": "NC",
            "postal_code": "283763112",
            "country_code": "US",
            "telephone_number": "910-676-8019",
            "fax_number": "910-676-8009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "AMANDA",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "LCSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-19",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P016400",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Gay Rose, RN
• Samisha Tankeyia Rose
• Shannon Rose
• Carl Willis Rosenberg, LMFT
• Jennifer L Rosenthal-Dibb, MS CCC-SLP
• Charles J Ross, IDMT
• Jerlinda Gladys Camille Ross, M.D.
• Karen Ross
• Karlishia Shenay Ross
• Kellie Michelle Ross, LCAS

• Clinical Social Worker in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; 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.