Active NPI
Amanda Manske, LCSW, RPT
- Clinical Social Worker
- Lake City, FL
National Provider Identifier
1649985334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW19170
- Practice address
- 826 SW Main Blvd Ste 102
Lake City, FL 32025-5742 - Phone
- (386) 984-5366
- NPI assigned
- Jan 18, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW19170 | FL | Primary |
Addresses
Primary practice location
826 SW Main Blvd Ste 102
Lake City, FL 32025-5742
Mailing address
826 SW Main Blvd Ste 102
Lake City, FL 32025-5742
Phone (386) 984-5366
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sacredwingscounseling@gamil.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Clinical | Current | Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
Organizations & group practices 1
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": "1674000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694390400000",
"number": "1649985334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "826 SW MAIN BLVD STE 102",
"city": "LAKE CITY",
"state": "FL",
"postal_code": "320255742",
"telephone_number": "386-984-5366",
"fax_number": "386-287-6525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "826 SW MAIN BLVD STE 102",
"city": "LAKE CITY",
"state": "FL",
"postal_code": "320255742",
"telephone_number": "386-984-5366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANSKE",
"first_name": "AMANDA",
"credential": "LCSW, RPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-18",
"last_updated": "2023-09-11",
"certification_date": "2023-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW19170",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sacredwingscounseling@gamil.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "826 SW Main Blvd Ste 102",
"city": "Lake City",
"state": "FL",
"country_code": "US",
"postal_code": "320255742",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Lake City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.