Amanda Adhami, MSW, LCSW
Individual provider Active NPI Clinical Social Worker · Bloomington, IN
NPI 1669931341 · NPPES record last updated Feb 24, 2022
Key facts
- NPI
- 1669931341
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Practice address
- 645 N Walnut St
Bloomington, IN 47404-3846 - Phone
- (812) 336-3570
- Fax
- (812) 336-9010
- NPI assigned
- Mar 13, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33008127A | IN | MD | Addiction (Substance Use Disorder) Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crescent Counseling LLC | Clinical | Current | Accepting new patients |
| Rahma Therapy | Clinical | Current | Accepting new patients |
| Amethyst House, Inc. | Past | Accepting new patients | |
| Amethyst House | Clinical | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Yes | ||
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | 33008127A | IN |
Addresses
Primary practice location
645 N Walnut St
Bloomington, IN 47404-3846
Mailing address
6351 Creekview LN
Fishers, IN 46038-2091
Phone (812) 369-9128
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33008218A | Other | IN | COMMERCIAL |
| 33008218A | Medicaid | IN | |
| 34009199A | Medicaid | IN |
Other providers in Bloomington, IN
- Laurel Adams
- Matthew Wayne Adams
- Melanie Adams
- Adamson Medical LLC
- Aderinola Adewopo
- Brittany Adkins
- Kaitlyn Adkins
- Emil J Adsit
- Ananya Adur
- Advanced Therapeutic Equipment
All providers in Bloomington, IN · Clinical Social Worker in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 24, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.