Amanda Marie Perez, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05453600 Issued in NJ

Practice address

51 Upper Montclair PLZ Ste 24
Upper Montclair, NJ 07043-1340

Phone

(862) 305-0590

NPI assigned

Jul 8, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1437461324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 RIDGE RD APT B",
            "city": "CEDAR GROVE",
            "state": "NJ",
            "postal_code": "070092058",
            "telephone_number": "862-305-0590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 UPPER MONTCLAIR PLZ STE 24",
            "city": "UPPER MONTCLAIR",
            "state": "NJ",
            "postal_code": "070431340",
            "telephone_number": "862-305-0590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 Ridgedale Ave",
            "address_purpose": "LOCATION",
            "city": "Florham Park",
            "state": "NJ",
            "postal_code": "079321349",
            "country_code": "US",
            "telephone_number": "212-560-2437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-08",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05453600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Upper Montclair, NJ
• Providers in Upper Montclair, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.