Amanda R Lewis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.018245 Issued in IL

Practice address

1405 N Green Mount Rd Ste 230
O Fallon, IL 62269-3494

Phone

(618) 334-5571

Fax

(618) 551-8955

NPI assigned

Sep 26, 2014

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

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Amanda Lewis, MSW, LCSW, LLC

  • Community/Behavioral Health Agency
  • Shiloh, IL
  • NPI 1598110124
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1411689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1518360171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 N GREEN MOUNT RD STE 230",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622693494",
            "telephone_number": "618-334-5571",
            "fax_number": "618-551-8955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 N GREEN MOUNT RD STE 230",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622693494",
            "telephone_number": "618-334-5571",
            "fax_number": "618-551-8955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1161 Fortune Blvd",
            "address_purpose": "LOCATION",
            "city": "Shiloh",
            "state": "IL",
            "postal_code": "622697385",
            "country_code": "US",
            "telephone_number": "618-334-5571",
            "fax_number": "618-206-8476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "AMANDA",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-26",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.018245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara M Lester, MPT
• Tameka Lesueur, RBT
• Lindsay A Levault, PTA
• Louis Jay Levine, MD
• Kelly Lewey, PT
• Nicholas G Lezama, MD
• Audri Nichole Linton
• Melissa Lisk, M.A., CF-SLP/L
• Brian Litland
• Amanda Littlefield, DMD

• Clinical Social Worker in O Fallon, IL
• Providers in O Fallon, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.