Active NPI
Amanda Averill, MSW, LISW, LICSW
- Clinical Social Worker
- West Chester, OH
National Provider Identifier
1427775857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I.2107752
- Practice address
- 4441 Tylers Vis
West Chester, OH 45069-7757 - Phone
- (612) 655-9367
- NPI assigned
- Oct 26, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 21802 | MN | |
| Clinical Social Worker | 1041C0700X | I.2107752 | OH | Primary |
Addresses
Primary practice location
4441 Tylers Vis
West Chester, OH 45069-7757
Mailing address
4441 Tylers Vis
West Chester, OH 45069-7757
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
| License | State | Type | Specialty |
|---|---|---|---|
| 21802 | MN | MD | Clinical Social Worker |
| I.2107752 | OH | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666742400000",
"number": "1427775857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4441 TYLERS VIS",
"city": "WEST CHESTER",
"state": "OH",
"postal_code": "450697757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4441 TYLERS VIS",
"city": "WEST CHESTER",
"state": "OH",
"postal_code": "450697757",
"telephone_number": "612-655-9367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVERILL",
"first_name": "AMANDA",
"credential": "MSW, LISW, LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-10-26",
"last_updated": "2022-10-26",
"certification_date": "2022-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "21802",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "I.2107752",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Chester, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.