Individual provider Active NPI

Amanda Young

  • Clinical Social Worker
  • Rocky River, OH
National Provider Identifier
1265305023
Registry record updated Sep 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0009725-SUPV Issued in OH
Practice address
20525 Center Ridge Rd
Rocky River, OH 44116-3437
Phone
(216) 200-8814
NPI assigned
Sep 27, 2025
Last updated
Sep 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.0009725-SUPV OH Primary

Addresses

Primary practice location

20525 Center Ridge Rd
Rocky River, OH 44116-3437

Mailing address

20525 Center Ridge Rd
Rocky River, OH 44116-3437
Phone (216) 200-8814

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
I.0009725-SUPVOHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1758931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758931200000",
    "number": "1265305023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20525 CENTER RIDGE RD",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441163437",
            "telephone_number": "216-200-8814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20525 CENTER RIDGE RD",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441163437",
            "telephone_number": "216-200-8814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-27",
        "last_updated": "2025-09-27",
        "certification_date": "2025-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0009725-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky River, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2025; 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.