Individual provider Active NPI

Amy Lee Waldman, MSW

  • Clinical Social Worker
  • Northampton, MA
National Provider Identifier
1588790968
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1026948 Issued in MA
Practice address
16 Center St
Suite 509
Northampton, MA 01060-3031
Phone
(413) 584-8400
NPI assigned
Feb 27, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1026948 MA Primary

Addresses

Primary practice location

16 Center St
Suite 509
Northampton, MA 01060-3031

Mailing address

16 Center St
Suite 509
Northampton, MA 01060-3031
Phone (413) 584-8400

Other identifiers 1

IdentifierTypeStateIssuer
WAPO7400OtherMABLUE CROSS NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Nov 29, 2023 through Nov 29, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1026948MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588790968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 CENTER ST",
            "address_2": "SUITE 509",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010603031",
            "telephone_number": "413-584-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 CENTER ST",
            "address_2": "SUITE 509",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010603031",
            "telephone_number": "413-584-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDMAN",
        "first_name": "AMY",
        "middle_name": "LEE",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1026948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS NUMBER",
            "identifier": "WAPO7400",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northampton, MA

Sources for this page

Verify at the official NPI Registry.