Individual provider Active NPI

Amanda Beall

  • Clinical Social Worker
  • Athens, OH
National Provider Identifier
1568956068
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2002346-SUPV Issued in OH
Practice address
11 Graham Dr
Athens, OH 45701
Phone
(800) 321-8293
NPI assigned
Jun 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.2002346-SUPV OH Primary
Social Worker 104100000X

Addresses

Primary practice location

11 Graham Dr
Athens, OH 45701

Mailing address

PO Box 132
Athens, OH 45701-0132

Other names 1

  • Amanda Dawn Wolfe Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20201201003166 OH Practitioner - Clinical Social Worker 0042621716 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.2002346-SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brave Health Medical Group PA CurrentSince Jan 23, 2026 Accepting new patients
Integrated Services for Behavioral Health PastSince Sep 10, 2020 Accepting new patients

Locations

675 Alpha Dr
Ste E108
Highland Heights, OH 44143

Organizations & group practices 2

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": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1568956068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 132",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457010132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 GRAHAM DR",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "45701",
            "telephone_number": "800-321-8293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEALL",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-18",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2002346-SUPV",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "WOLFE",
            "middle_name": "DAWN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Athens, OH

Sources for this page

Verify at the official NPI Registry.