Individual provider Active NPI

Amberly Edgley Kincaid, BCD, LISW, QMPH

  • Clinical Social Worker
  • Fort Thomas, KY
National Provider Identifier
1679505390
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3284 Issued in KY
Practice address
511 N Fort Thomas Ave
Fort Thomas, KY 41075-1505
Phone
(859) 653-0588
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 60486
Clinical Social Worker 1041C0700X 3284 KY Primary
Clinical Social Worker 1041C0700X I.1201475 OH

Addresses

Primary practice location

511 N Fort Thomas Ave
Fort Thomas, KY 41075-1505

Mailing address

511 N Fort Thomas Ave
Fort Thomas, KY 41075-1505
Phone (859) 653-0588

Other identifiers 1

IdentifierTypeStateIssuer
184607OtherKYMEDICARE GROUP NUMBER

Other names 1

  • Amberly Edgley Stepehenson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20250225000347 TX Practitioner - Clinical Social Worker 6608050091 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1201475OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rosebud Indian Health Service CurrentSince Jan 12, 2025 Accepting new patients
Quentin N Burdick Comprehensive Health Care Facility CurrentSince Mar 17, 2025 Accepting new patients
Rosebud Indian Health Service CurrentSince Jan 12, 2025 Accepting new patients
Northern Kentucky Mental Health Mental Retardation Regional Board Past Accepting new patients

Locations

1300 Hospital Loop
Belcourt, ND 58316

4100 W 150th St
#3
Cleveland, OH 44135

Organizations & group practices 4

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1679505390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 N FORT THOMAS AVE",
            "city": "FORT THOMAS",
            "state": "KY",
            "postal_code": "410751505",
            "telephone_number": "859-653-0588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 N FORT THOMAS AVE",
            "city": "FORT THOMAS",
            "state": "KY",
            "postal_code": "410751505",
            "telephone_number": "859-653-0588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINCAID",
        "first_name": "AMBERLY",
        "middle_name": "EDGLEY",
        "credential": "BCD, LISW, QMPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "60486",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "3284",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1201475",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "184607",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBERLY",
            "last_name": "STEPEHENSON",
            "middle_name": "EDGLEY",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Thomas, KY

Sources for this page

Verify at the official NPI Registry.