Active NPI
Amanda Rayburn Reagan, LCSW-S, LISW-S
- Clinical Social Worker
- Powell, OH
National Provider Identifier
1427340249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 51487
- Practice address
- 8170 Jerry Dr
Powell, OH 43065-6222 - Phone
- (713) 876-7990
- NPI assigned
- May 12, 2011
- 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 | 51487 | TX | Primary |
Addresses
Primary practice location
8170 Jerry Dr
Powell, OH 43065-6222
Mailing address
8170 Jerry Dr
Powell, OH 43065-6222
Phone (713) 876-7990
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 282721401 | Other | TX | TPI |
Other names 1
- Amanda Leigh Rayburn
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 |
|---|---|---|---|
| 51487 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arise Health Associates, P.a. | Clinical | Current | Accepting new patients |
| Teladoc Health Medical Group, P.a. | Clinical | Current | Accepting new patients |
| Family Psychsolutions | Past | Accepting new patients |
Interoperability endpoints
- amandareagan@tdh.allscriptsdirect.net
Organizations & group practices 3
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.
-
- Clinical Social Worker
- Katy, TX
- NPI 1881315323
-
- Clinical Psychologist
- Pearland, TX
- NPI 1841448594
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694563200000",
"number": "1427340249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8170 JERRY DR",
"city": "POWELL",
"state": "OH",
"postal_code": "430656222",
"telephone_number": "713-876-7990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8170 JERRY DR",
"city": "POWELL",
"state": "OH",
"postal_code": "430656222",
"telephone_number": "713-876-7990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REAGAN",
"first_name": "AMANDA",
"middle_name": "RAYBURN",
"credential": "LCSW-S, LISW-S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-12",
"last_updated": "2023-09-13",
"certification_date": "2023-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "51487",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TPI",
"identifier": "282721401",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "AMANDA",
"last_name": "RAYBURN",
"middle_name": "LEIGH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Powell, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.