Individual provider Active NPI

Amanda Jensen, LMSW

  • Social Worker
  • Austin, TX
National Provider Identifier
1235671504
Registry record updated Nov 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
63000 Issued in TX
Practice address
4131 Spicewood Springs Rd
Suite F1
Austin, TX 78759-8661
Phone
(210) 771-3872
NPI assigned
Nov 17, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 63000 TX Primary

Addresses

Primary practice location

4131 Spicewood Springs Rd
Suite F1
Austin, TX 78759-8661

Mailing address

4131 Spicewood Springs Rd
Suite F1
Austin, TX 78759-8661
Phone (210) 771-3872

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
63000TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1479340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479340800000",
    "number": "1235671504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 SPICEWOOD SPRINGS RD",
            "address_2": "SUITE F1",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787598661",
            "telephone_number": "210-771-3872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 SPICEWOOD SPRINGS RD",
            "address_2": "SUITE F1",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787598661",
            "telephone_number": "210-771-3872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "AMANDA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-17",
        "last_updated": "2016-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "63000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; 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.