Individual provider Active NPI

Amanda Elizabeth Avant, LCSW

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1376063917
Registry record updated Jun 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34007109A Issued in IN
Practice address
6130 Michigan Rd
Indianapolis, IN 46228-1200
Phone
(317) 925-2833
Fax
(317) 896-0360
NPI assigned
Jun 25, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 34007109A IN Primary

Addresses

Primary practice location

6130 Michigan Rd
Indianapolis, IN 46228-1200

Mailing address

15231 Dry Creek Rd
Noblesville, IN 46060-4642
Phone (317) 416-1476

Other identifiers 1

IdentifierTypeStateIssuer
201225250AMedicaidIN

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
34007109AINMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1498348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498348800000",
    "number": "1376063917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15231 DRY CREEK RD",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460604642",
            "telephone_number": "317-416-1476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6130 MICHIGAN RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462281200",
            "telephone_number": "317-925-2833",
            "fax_number": "317-896-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVANT",
        "first_name": "AMANDA",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-25",
        "last_updated": "2017-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007109A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201225250A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2017; 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.