Individual provider Active NPI

Amanda Lewis, LCSW

  • Clinical Social Worker
  • Killeen, TX
National Provider Identifier
1467927871
Registry record updated Oct 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
64792 Issued in TX
Practice address
179 Gann Branch Rd
Killeen, TX 76549-3862
Phone
(254) 987-0405
Fax
(254) 200-4486
NPI assigned
Oct 11, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 64792 TX Primary

Addresses

Primary practice location

179 Gann Branch Rd
Killeen, TX 76549-3862

Mailing address

179 Gann Branch Rd
Killeen, TX 76549-3862
Phone (254) 987-0405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20210510000640 AL Practitioner - Clinical Social Worker 6608117304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Alabama School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

557 Glover Ave
Suite 3
Enterprise, AL 36330-2070
Phone (334) 308-2292

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
64792TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Afl Counseling and Consulting, LLC Clinical CurrentSince Mar 15, 2021 Accepting new patients

Locations

557 Glover Ave
Ste 3
Enterprise, AL 36330
Phone (334) 308-2292

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": "1539216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539216000000",
    "number": "1467927871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 GANN BRANCH RD",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765493862",
            "telephone_number": "254-987-0405",
            "fax_number": "254-200-4486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 GANN BRANCH RD",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765493862",
            "telephone_number": "254-987-0405",
            "fax_number": "254-200-4486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "AMANDA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-11",
        "last_updated": "2018-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "64792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Killeen, TX

Sources for this page

Verify at the official NPI Registry.