Individual provider Active NPI

Amanda M Cruz, LCSW

  • Clinical Social Worker
  • Fort Myers, FL
National Provider Identifier
1255671699
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904018252 Issued in VA
Practice address
4310 Metro Pkwy Ste 205
Fort Myers, FL 33916-9416
Phone
(239) 690-6906
NPI assigned
Feb 21, 2013
Last updated
Mar 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW17167 FL
Clinical Social Worker 1041C0700X 0904018252 VA Primary

Addresses

Primary practice location

4310 Metro Pkwy Ste 205
Fort Myers, FL 33916-9416

Mailing address

4310 Metro Pkwy Ste 205
Fort Myers, FL 33916-9416
Phone (239) 275-3222

Other practice location 1

4429 Bonney Rd Ste 120
Virginia Beach, VA 23462-3876
Phone (757) 606-1377

Other practice location 2

516 Innovation Dr Ste 305
Chesapeake, VA 23320-3866
Phone (757) 606-1377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200817000776 FL Practitioner - Clinical Social Worker 3678999067 Reassigns benefits to 1 organization
I20260414000193 VA Practitioner - Clinical Social Worker 3678999067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4310 Metro Pkwy
Suite 205
Fort Myers, FL 33916-9416
Phone (239) 223-2751

Merit-based Incentive Payment System (MIPS)

Final score
87.43 of 100Reported as group
Quality
74.02
Promoting interoperability
100
Improvement activities
40
Cost
77.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904018252VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dna Comprehensive Therapy Services, LLC PastSince Jun 16, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: amanda.cruz.1@13142.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1255671699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 METRO PKWY STE 205",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339169416",
            "telephone_number": "239-275-3222",
            "fax_number": "239-791-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 METRO PKWY STE 205",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339169416",
            "telephone_number": "239-690-6906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4429 Bonney Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234623876",
            "country_code": "US",
            "telephone_number": "757-606-1377",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "516 Innovation Dr Ste 305",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233203866",
            "country_code": "US",
            "telephone_number": "757-606-1377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "AMANDA",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-21",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW17167",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904018252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.