Amanda Tickle

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

S.1903548 Issued in OH

Practice address

1158 Westwood Dr
Van Wert, OH 45891-2449

Phone

(419) 238-3434

NPI assigned

Sep 8, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Amanda Williams Former name

Medicare fee-for-service enrollment

Enrolled in OH

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Westwood Behavioral Health Center, Inc.Group PAC ID 6901794015, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Westwood Behavioral Health Center, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Van Wert, OH
  • NPI 1639108764
  Medicare reassignment Care Compare group NPD
• Westwood Behavioral Health Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Paulding, OH
  • NPI 1053505339
  NPD
• Paulding Counseling Center

  • Mental Health Counselor
  • Paulding, OH
  • NPI 1487646865
  NPD (past)

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

{
    "created_epoch": "1504828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557964800000",
    "number": "1386162469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1158 WESTWOOD DR",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458912449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1158 WESTWOOD DR",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458912449",
            "telephone_number": "419-238-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICKLE",
        "first_name": "AMANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-08",
        "last_updated": "2019-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.1700279-TRNE",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.1903548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "WILLIAMS",
            "credential": "LSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Clinical Social Worker in Van Wert, OH
• Providers in Van Wert, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; 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.