Individual provider Active NPI

Amanda Youth, LCSW

  • Clinical Social Worker
  • Aiea, HI
National Provider Identifier
1558718783
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4544 Issued in HI
Practice address
99-080 Kauhale St Ste C20
Aiea, HI 96701-4114
Phone
(808) 707-7556
NPI assigned
May 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4544 HI Primary

Addresses

Primary practice location

99-080 Kauhale St Ste C20
Aiea, HI 96701-4114

Mailing address

99-080 Kauhale St Ste C20
Aiea, HI 96701-4114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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

Enrollment IDStateProvider typePAC IDDetails
I20210922000804 HI Practitioner - Clinical Social Worker 5890192637 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4544HIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Imua Health Group, LLC Clinical CurrentSince Aug 27, 2021 Accepting new patients
Maulihiwa Wellness, LLC PastSince Jun 11, 2019 Accepting new patients
Imua Heart PastSince Jul 2, 2023 Accepting new patients

Locations

99-080 Kauhale St
Ste C20
Aiea, HI 96701
Phone (808) 320-1025

99-080 Kauhale St
Ste C20
Aiea, HI 96701
Phone (808) 320-1025

46-005 Kawa St
Ste 203
Kaneohe, HI 96744
Phone (808) 247-9616

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1558718783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99-080 KAUHALE ST STE C20",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967014114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99-080 KAUHALE ST STE C20",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967014114",
            "telephone_number": "808-707-7556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUTH",
        "first_name": "AMANDA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-18",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "4544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiea, HI

Sources for this page

Verify at the official NPI Registry.