Active NPI
Amanda Prentice, MSW, LCSW
- Clinical Social Worker
- Concord, NC
National Provider Identifier
1437566031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C009261
- Practice address
- 363 Church St N
Suite 200
Concord, NC 28025-4589 - Phone
- (704) 262-1348
- NPI assigned
- Jul 15, 2014
- Sex
- Female
- Sole proprietor
- No
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 | P007219 | NC | |
| Clinical Social Worker | 1041C0700X | C009261 | NC | Primary |
Addresses
Primary practice location
363 Church St N
Suite 200
Concord, NC 28025-4589
Mailing address
109 Penny St
Albemarle, NC 28001-2803
Phone (704) 985-1178
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 |
|---|---|---|---|
| C009261 | NC | MD | Clinical Social Worker |
| P007219 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Clinical | Current | Accepting new patients |
Interoperability endpoints
- amandaporter@tdh.allscriptsdirect.net
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429056000000",
"number": "1437566031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 PENNY ST",
"city": "ALBEMARLE",
"state": "NC",
"postal_code": "280012803",
"telephone_number": "704-985-1178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "363 CHURCH ST N",
"address_2": "SUITE 200",
"city": "CONCORD",
"state": "NC",
"postal_code": "280254589",
"telephone_number": "704-262-1348"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRENTICE",
"first_name": "AMANDA",
"credential": "MSW, LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-15",
"last_updated": "2015-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P007219",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C009261",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.