Individual provider Active NPI

Amanda Juza-Hamrick, LCSW

  • Clinical Social Worker
  • Redmond, OR
National Provider Identifier
1457718421
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L7590 Issued in OR
Practice address
818 SW Forest Ave
Redmond, OR 97756-2737
Phone
(541) 293-3039
NPI assigned
Jan 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X L7590 OR Primary

Addresses

Primary practice location

818 SW Forest Ave
Redmond, OR 97756-2737

Mailing address

8114 SW Pokegama Dr
Powell Butte, OR 97753-1564
Phone (541) 668-1692

Other practice location 1

8114 SW Pokegama Dr
Powell Butte, OR 97753-1564
Phone (541) 293-3039

Other practice location 2

61396 S Hwy 97
Bend, OR 97702-2157
Phone (541) 293-3039

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

LicenseStateTypeSpecialty
L7590ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Mind Body Psychotherapy LLC CurrentSince Nov 10, 2024 Accepting new patients

Locations

818 SW Forest Ave
Ste B
Redmond, OR 97756
Phone (541) 293-3039

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": "1453334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1457718421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8114 SW POKEGAMA DR",
            "city": "POWELL BUTTE",
            "state": "OR",
            "postal_code": "977531564",
            "telephone_number": "541-668-1692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 SW FOREST AVE",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977562737",
            "telephone_number": "541-293-3039"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8114 SW Pokegama Dr",
            "address_purpose": "LOCATION",
            "city": "Powell Butte",
            "state": "OR",
            "postal_code": "977531564",
            "country_code": "US",
            "telephone_number": "541-293-3039",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "61396 S Hwy 97",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977022157",
            "country_code": "US",
            "telephone_number": "541-293-3039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUZA-HAMRICK",
        "first_name": "AMANDA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-21",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L7590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.