Individual provider Active NPI

Amy Olson

  • Clinical Social Worker
  • Orlando, FL
National Provider Identifier
1679294870
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
20298 Issued in FL
Practice address
7446 Pinemount Dr
Orlando, FL 32819-4663
Phone
(407) 694-5890
NPI assigned
Sep 6, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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 20298 FL Primary

Addresses

Primary practice location

7446 Pinemount Dr
Orlando, FL 32819-4663

Mailing address

7446 Pinemount Dr
Orlando, FL 32819-4663
Phone (407) 694-5890

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221027001184 FL Practitioner - Clinical Social Worker 5496122897 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20298FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Recovery Network LLC CurrentSince Nov 7, 2022 Accepting new patients

Locations

260 Lookout Pl
Ste 202
Maitland, FL 32751
Phone (407) 537-9450

10125 W Colonial Dr
Ste 212
Ocoee, FL 34761
Phone (407) 753-7441

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

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": "1662422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1679294870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7446 PINEMOUNT DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328194663",
            "telephone_number": "407-694-5890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7446 PINEMOUNT DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328194663",
            "telephone_number": "407-694-5890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "AMY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-06",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "20298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.