Amanda Forrest, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW9272 Issued in FL

Practice address

1536 N Jefferson St
Jacksonville, FL 32209-6525

Phone

(904) 470-6900

NPI assigned

Oct 14, 2009

Last updated

Jun 9, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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 1

Specialty

Clinical Social Worker

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Wildflowers & Weeds

  • Clinical Social Worker
  • Jacksonville, FL
  • NPI 1508437773
  Medicare reassignment NPD Authorized official
• Cotler Healthcare & Development Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wellington, FL
  • NPI 1225075047
  Medicare reassignment NPD

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

{
    "created_epoch": "1255478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1346575057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "778 PORT WINE LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322255230",
            "telephone_number": "904-220-5123",
            "fax_number": "904-642-9108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1536 N JEFFERSON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096525",
            "telephone_number": "904-470-6900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4110 SOUTHPOINT BLVD",
            "address_2": "STE 116",
            "address_purpose": "LOCATION",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322160925",
            "country_code": "US",
            "telephone_number": "904-642-9100",
            "fax_number": "904-642-9108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORREST",
        "first_name": "AMANDA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-14",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ferdinand Joseph Formoso, D.O.
• Abigail Victoria Forness, M.S. CCC-SLP
• Masleidy Fornos Artiles, APRN
• Juliana Forrest-Lytle, PHD, LMHC
• Adam James Forrest, D.O.
• Jesse Forshey Friedman, ARNP
• John G. Forster, MD
• Rebecca Forster, APRN
• Robert J Forster, MD
• Fort Caroline Clinic of Chiropractic

• Clinical Social Worker in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.