Individual provider Active NPI

Amanda Marie Estioco

  • Clinical Social Worker
  • Detroit, MI
National Provider Identifier
1447854112
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801107422 Issued in MI
Practice address
10 Peterboro St
Detroit, MI 48201-2722
Phone
(313) 831-3160
NPI assigned
Nov 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801107422 MI Primary

Addresses

Primary practice location

10 Peterboro St
Detroit, MI 48201-2722

Mailing address

555 Brush St Apt 1802
Detroit, MI 48226-4333
Phone (313) 622-0385

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240612001742 MI Practitioner - Clinical Social Worker 6608318183 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neighborhood Service OrganizationGroup PAC ID 7113907387, 11 clinicians

Practice addresses (Care Compare)

882 Oakman Blvd
Suite C
Detroit, MI 48238-4019
Phone (313) 961-4890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801107422MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Service Organization CurrentSince Apr 20, 2024 Accepting new patients

Locations

8600 Woodward Ave
Detroit, MI 48202
Phone (313) 875-7601

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": "1606176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1447854112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 BRUSH ST APT 1802",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482264333",
            "telephone_number": "313-622-0385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PETERBORO ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012722",
            "telephone_number": "313-831-3160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTIOCO",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-24",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801107422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.