Individual provider Active NPI

Amanda Brooke Allen, LCSW

  • Clinical Social Worker
  • Pensacola, FL
National Provider Identifier
1598389041
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11757 Issued in LA
Practice address
9013 University Pkwy Ste C
Pensacola, FL 32514-9421
Phone
(850) 478-7800
NPI assigned
Jun 1, 2020
Last updated
Nov 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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 11757 LA Primary

Addresses

Primary practice location

9013 University Pkwy Ste C
Pensacola, FL 32514-9421

Mailing address

9013 University Pkwy Ste C
Pensacola, FL 32514-9421
Phone (850) 478-7800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210819001402 FL Practitioner - Clinical Social Worker 1850796426 Reassigns benefits to 1 organization
I20230927000608 KY Practitioner - Clinical Social Worker 1850796426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Meridian Behavioral Health IncGroup PAC ID 6709149321, 17 clinicians

Practice addresses (Care Compare)

4010 Dupont Cir
Suite 419
Louisville, KY 40207-4837
Phone (502) 409-6993

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11757LAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Stone Ridge Counseling Center Inc Clinical CurrentSince Jul 12, 2021 Accepting new patients
Meridian Behavioral Health, Inc CurrentSince Sep 15, 2023 Accepting new patients

Locations

9013 University Pkwy
Ste C
Pensacola, FL 32514
Phone (850) 380-8320

4010 DuPont Cir
Ste 419
Louisville, KY 40207
Phone (502) 409-6993

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1590969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1598389041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9013 UNIVERSITY PKWY STE C",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325149421",
            "telephone_number": "850-478-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9013 UNIVERSITY PKWY STE C",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325149421",
            "telephone_number": "850-478-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "AMANDA",
        "middle_name": "BROOKE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-01",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "11757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.