Individual provider Active NPI

Amy Van Lenten, LCSW

  • Clinical Social Worker
  • Eglin Afb, FL
National Provider Identifier
1376397778
Registry record updated Aug 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW21744 Issued in FL
Practice address
307 Boatner Rd Ste 114
Eglin Afb, FL 32542-1302
Phone
(850) 833-8115
NPI assigned
Apr 12, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW21744 FL Primary

Addresses

Primary practice location

307 Boatner Rd Ste 114
Eglin Afb, FL 32542-1302

Mailing address

307 Boatner Rd Ste 114
Eglin Afb, FL 32542-1302
Phone (850) 833-8115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

7261 Sheridan St
Suite 340
Hollywood, FL 33024-2706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW21744FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1712880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1376397778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD STE 114",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421302",
            "telephone_number": "850-833-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD STE 114",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421302",
            "telephone_number": "850-833-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN LENTEN",
        "first_name": "AMY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-12",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW21744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eglin Afb, FL

Sources for this page

Verify at the official NPI Registry.