Amy Divincenzo LCSW LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

AMY DIVINCENZO LCSW LLC

Practice address

1328 Lawrence Ave
Indianapolis, IN 46227-3749

Phone

(317) 252-3575

Fax

(463) 271-7784

NPI assigned

Feb 23, 2023

Last updated

Feb 23, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amy Divincenzo, LCSWNPI 1104200567

Title

Owner

Phone

(317) 252-3575

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amy Divincenzo, MSW

  • Social Worker
  • Indianapolis, IN
  • NPI 1104200567
  NPD Authorized official

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

{
    "created_epoch": "1677110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677110400000",
    "number": "1568161099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1328 LAWRENCE AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462273749",
            "telephone_number": "317-252-3575",
            "fax_number": "463-271-7784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 LAWRENCE AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462273749",
            "telephone_number": "317-252-3575",
            "fax_number": "463-271-7784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMY DIVINCENZO LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-23",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A",
        "authorized_official_last_name": "DIVINCENZO",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-252-3575",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; 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.