Individual provider Active NPI

Amanda Jorgenson, LMSW, CSW-I

  • Clinical Social Worker
  • Reno, NV
National Provider Identifier
1477966893
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
IC-2062 Issued in NV
Practice address
855 W 7TH St
Reno, NV 89503-2745
Phone
(775) 677-2216
NPI assigned
Jun 3, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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 IC-2062 NV Primary

Addresses

Primary practice location

855 W 7TH St
Reno, NV 89503-2745

Mailing address

855 W 7TH St
Reno, NV 89503-2745
Phone (775) 677-2216

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
IC-2062NVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Maple Star Nevada CurrentSince Nov 20, 2022 Accepting new patients
Hope Healthcare Services Past Accepting new patients
Hope Healthcare Services Past Accepting new patients

Locations

855 W 7th St
Reno, NV 89503
Phone (775) 720-5483

Organizations & group practices 3

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": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1477966893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 W 7TH ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895032745",
            "telephone_number": "775-677-2216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 W 7TH ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895032745",
            "telephone_number": "775-677-2216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORGENSON",
        "first_name": "AMANDA",
        "credential": "LMSW, CSW-I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-03",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "IC-2062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.