Active NPI
Amanda Hardeman
- Social Worker
- Forest Park, GA
National Provider Identifier
1235891623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- MSW008757
- Practice address
- 4442 Rock Valley Dr
Forest Park, GA 30297-1582 - Phone
- (404) 713-2916
- NPI assigned
- Oct 12, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | MSW008757 | GA | Primary |
Addresses
Primary practice location
4442 Rock Valley Dr
Forest Park, GA 30297-1582
Mailing address
4442 Rock Valley Dr
Forest Park, GA 30297-1582
Phone (404) 713-2916
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
| License | State | Type | Specialty |
|---|---|---|---|
| MSW008757 | GA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633996800000",
"number": "1235891623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4442 ROCK VALLEY DR",
"city": "FOREST PARK",
"state": "GA",
"postal_code": "302971582",
"telephone_number": "404-713-2916"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4442 ROCK VALLEY DR",
"city": "FOREST PARK",
"state": "GA",
"postal_code": "302971582",
"telephone_number": "404-713-2916"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARDEMAN",
"first_name": "AMANDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-12",
"last_updated": "2021-10-12",
"certification_date": "2021-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "GA",
"license": "MSW008757",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Park, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.