Active NPI
Amy Renee Pugh, LSCSW
- Clinical Social Worker
- Wichita, KS
National Provider Identifier
1346611605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 4362
- Practice address
- 2919 W 2ND St N
Wichita, KS 67203-5319 - Phone
- (316) 200-2233
- NPI assigned
- Oct 13, 2015
- Last updated
- Oct 13, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 | 4362 | KS | Primary |
Addresses
Primary practice location
2919 W 2ND St N
Wichita, KS 67203-5319
Mailing address
12502 SW 36TH St
Halstead, KS 67056-9386
Phone (316) 200-2233
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 |
|---|---|---|---|
| 4362 | KS | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444694400000",
"number": "1346611605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12502 SW 36TH ST",
"city": "HALSTEAD",
"state": "KS",
"postal_code": "670569386",
"telephone_number": "316-200-2233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2919 W 2ND ST N",
"city": "WICHITA",
"state": "KS",
"postal_code": "672035319",
"telephone_number": "316-200-2233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUGH",
"first_name": "AMY",
"middle_name": "RENEE",
"credential": "LSCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-13",
"last_updated": "2015-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KS",
"license": "4362",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.