Individual provider Active NPI

Amy Sue Thatcher, LCSW

  • Mental Health Counselor
  • Lakewood Ranch, FL
National Provider Identifier
1386705077
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
SW8459 Issued in FL
Practice address
5319 Paylor LN Ste 100
Lakewood Ranch, FL 34240-2207
Phone
(941) 587-2055
Fax
(941) 499-0404
NPI assigned
Dec 13, 2006
Last updated
Jul 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X SW8459 FL Primary

Addresses

Primary practice location

5319 Paylor LN Ste 100
Lakewood Ranch, FL 34240-2207

Mailing address

2492 S Macafee Rd
Sayre, PA 18840-7821
Phone (941) 587-2055

Other practice location 1

2492 S MacAfee Rd
Sayre, PA 18840-7821
Phone (941) 587-2055

Other identifiers 1

IdentifierTypeStateIssuer
000030600MedicaidFL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090213000106 FL Practitioner - Clinical Social Worker 0143385898 Practice locations: Lakewood Ranch, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5319 Paylor LN
Suite 100
Lakewood Ranch, FL 34240-2207
Phone (941) 587-2055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW8459FLMDMental Health Counselor

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1386705077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2492 S MACAFEE RD",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188407821",
            "telephone_number": "941-587-2055",
            "fax_number": "941-499-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5319 PAYLOR LN STE 100",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342402207",
            "telephone_number": "941-587-2055",
            "fax_number": "941-499-0404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2492 S MacAfee Rd",
            "address_purpose": "LOCATION",
            "city": "Sayre",
            "state": "PA",
            "postal_code": "188407821",
            "country_code": "US",
            "telephone_number": "941-587-2055",
            "fax_number": "941-499-0404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THATCHER",
        "first_name": "AMY",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW8459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000030600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood Ranch, FL

Sources for this page

Verify at the official NPI Registry.