Active NPI
Amanda M Ienna, LMSW
- Clinical Social Worker
- Rochester Hills, MI
National Provider Identifier
1285987370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801091171
- Practice address
- 110 South Blvd W Ste 200
Rochester Hills, MI 48307-5184 - Phone
- (248) 844-6234
- NPI assigned
- Oct 26, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801091171 | MI | Primary |
Addresses
Primary practice location
110 South Blvd W Ste 200
Rochester Hills, MI 48307-5184
Mailing address
440 N Wolfe Rd
Sunnyvale, CA 94085-3869
Phone (888) 688-9296
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801091171 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643932800000",
"number": "1285987370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "440 N WOLFE RD",
"city": "SUNNYVALE",
"state": "CA",
"postal_code": "940853869",
"telephone_number": "888-688-9296"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 SOUTH BLVD W STE 200",
"city": "ROCHESTER HILLS",
"state": "MI",
"postal_code": "483075184",
"telephone_number": "248-844-6234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IENNA",
"first_name": "AMANDA",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-26",
"last_updated": "2022-02-04",
"certification_date": "2022-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801091171",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.