Amanda G Phelan, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15471 Issued in MD

Practice address

5229 New Design Rd
Frederick, MD 21703-7103

Phone

(240) 415-8620

NPI assigned

Oct 2, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Amanda C Glenn Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1518218445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5229 NEW DESIGN RD",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217037103",
            "telephone_number": "240-415-8620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5229 NEW DESIGN RD",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217037103",
            "telephone_number": "240-415-8620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELAN",
        "first_name": "AMANDA",
        "middle_name": "G",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-02",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "15471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "GLENN",
            "middle_name": "C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alberta Jane Peugeot, ARNP-C
• Leah Pfister
• Jeannie Pham, MD
• Karen Pheasant, DO
• Debra Sue Phebus
• Melanie Joanna Phelan
• Jayme Micaela Driver Phelps, APRN
• Sydni Phelps, SLP
• Philip J McGann MD,PA
• Hamblin Phillips

• Clinical Social Worker in Frederick, MD
• Providers in Frederick, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; 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.