Amy Jo Smith

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

S1000229 Issued in OH

Practice address

11 Graham Dr
Athens, OH 45701-1430

Phone

(740) 594-6807

NPI assigned

Apr 9, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Amy Jo Runyon Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Integrated Services for Behavioral Health

  • Community/Behavioral Health Agency
  • Nelsonville, OH
  • NPI 1205196201
  NPD (past)

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

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365465600000",
    "number": "1609219773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8148 CHASE RD",
            "city": "ALBANY",
            "state": "OH",
            "postal_code": "457108847",
            "telephone_number": "740-590-8717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 GRAHAM DR",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457011430",
            "telephone_number": "740-594-6807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AMY",
        "middle_name": "JO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-09",
        "last_updated": "2013-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S1000229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "RUNYON",
            "middle_name": "JO",
            "credential": "LISW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amelia Slone
• Kiara Slone
• Charles Ronald Smalling Jr., MD
• Miranda Smallwood
• Karen M Smart, CDCA
• Dean Christopher Smith
• Hannah Smith
• Jessie Smith
• Joslyn N Smith, QMHS
• Krista Smith

• Clinical Social Worker in Athens, OH
• Providers in Athens, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2013; 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.