Amy M Fialkoff, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801090897

Practice address

4625 Beckley Rd
Battle Creek, MI 49015-7948

Phone

(269) 979-8119

NPI assigned

Jul 8, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Amy M Shanahan Former name

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

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.

• Christian Counseling Center of Battle Creek Inc

  • Clinical Psychologist
  • Battle Creek, MI
  • NPI 1114166907
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587772800000",
    "number": "1508428772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 ESPANOLA AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490041102",
            "telephone_number": "269-532-8234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4625 BECKLEY RD",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490157948",
            "telephone_number": "269-979-8119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIALKOFF",
        "first_name": "AMY",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-08",
        "last_updated": "2020-04-25",
        "certification_date": "2020-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "6801090897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6801090897",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "169.254.225.86/16",
            "affiliation": "N",
            "address_1": "4625 Beckley Rd",
            "city": "Battle Creek",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490157948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "SHANAHAN",
            "middle_name": "M",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Haputhanthrige Jan Mariano Fernando
• Kaitlynn E Ferris, LLPC
• Kayla Ferris
• Janelle Fether, PHARMD
• Dominic Fetterly, DC
• Julie A Fisher, OTR
• Mesha Fisher
• Rachel Fisher
• Susan M Fisher, LLMSW
• Molly Evelyn Fiske, PHARMD

• Clinical Social Worker in Battle Creek, MI
• Providers in Battle Creek, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.