Amala John, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

21311 Issued in AZ

Practice address

4001 E Baseline Rd Ste 204
Gilbert, AZ 85234-2743

Phone

(480) 269-2971

Fax

(480) 452-0691

NPI assigned

Apr 19, 2023

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 AZ

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, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lighthouse Psychiatry LLCGroup PAC ID 0547545824, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amala.john.1@32088.direct.athenahealth.com

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.

• Lighthouse Psychiatry LLC

  • Psychiatry Physician
  • Gilbert, AZ
  • NPI 1326596719

  Clinical

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1681862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1538856695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 S VAL VISTA DR STE A3-659",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852961374",
            "telephone_number": "480-269-2971",
            "fax_number": "480-452-0691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 E BASELINE RD STE 204",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342743",
            "telephone_number": "480-269-2971",
            "fax_number": "480-452-0691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "AMALA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-19",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "21311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sabine Joachin, PHARMD
• Laura Jean Jochen, FNP-C
• John a. Hatch DDS PC
• John E. Culp, III DMD, PC
• John Kingsley MD PLLC
• Jijo John, MD
• Marjorie Mae Johns
• Timothy A Johns, MD
• Johnson & Larsen Family Dentistry
• Alanna Margaret Johnson, FNP-C

• Clinical Social Worker in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; 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.