Amanda Brunson, LCSW
Individual provider Active NPI Clinical Social Worker · Shalimar, FL
NPI 1508420175 · NPPES record last updated Jul 26, 2023
Key facts
- NPI
- 1508420175
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- SW16062 (FL)
- Practice address
- 1 11TH Ave Ste A2
Shalimar, FL 32579-1318 - Phone
- (850) 461-3167
- Fax
- (850) 979-8775
- NPI assigned
- Apr 29, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Dragonfly Counseling and Consulting, LLC
Practice addresses (Care Compare)
1 11TH Ave
Suite A2
Shalimar, FL 32579-1318
Phone (850) 468-2493
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250925002498 | FL | Practitioner - Clinical Social Worker | 1052816550 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW16062 | FL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dragonfly Counseling & Consulting, LLC | Current |
Accepting new patients |
Locations
1 11th Ave
Ste A2
Shalimar, FL 32579
Phone (850) 468-2493
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW16062 | FL | Yes |
Addresses
Primary practice location
1 11TH Ave Ste A2
Shalimar, FL 32579-1318
Mailing address
1 11TH Ave Ste A2
Shalimar, FL 32579-1318
Phone (850) 461-3167
Other providers in Shalimar, FL
- Bluewater Chiropractic Wellness Center LLC
- Rendi Bonner
- BRD Wellness PLLC
- Renae Morvlee Jodian Brown Eccleston
- Larry Brown II
- John Joseph Bullard
- Elizabeth Rose Burnham
- Stephanie Aldridge Butler
- Christine Campbell
- Elijah Earle Caver
All providers in Shalimar, FL · Clinical Social Worker in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.