Amannda A Walworth

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

078869 Issued in NY

Practice address

8115 164TH St
Jamaica, NY 11432-1118

Phone

(718) 380-3000

Fax

(718) 380-9475

NPI assigned

Mar 9, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1331251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1316212392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8115 164TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114321118",
            "telephone_number": "718-380-3000",
            "fax_number": "718-380-9475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8115 164TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114321118",
            "telephone_number": "718-380-3000",
            "fax_number": "718-380-9475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALWORTH",
        "first_name": "AMANNDA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-09",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "093066",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "078869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheena Andree Wallerson
• Danny Walls
• Taylor M Walsh, PA
• Helen Walter, NP
• Phylicia Walters
• Guohua Wang
• Linda Wang, MD
• Su Jin Wang, RPH
• Deanne Christina Warde
• Jayson Ware

• Clinical Social Worker in Jamaica, NY
• Providers in Jamaica, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.

Verify at the official NPI Registry.