Individual provider Active NPI

Amy L. Mishler, LCSW

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1679736490
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C006073 Issued in NC
Practice address
Behavioral Health Center CMC Randolph
501 Billingsley Road
Charlotte, NC 28211-1009
Phone
(704) 358-2700
Fax
(704) 358-2716
NPI assigned
Jul 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

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 C006073 NC Primary

Addresses

Primary practice location

Behavioral Health Center CMC Randolph
501 Billingsley Road
Charlotte, NC 28211-1009

Mailing address

Behavioral Health Center CMC Randolph
501 Billingsley Road
Charlotte, NC 28211-1009
Phone (704) 358-2710

Other identifiers 2

IdentifierTypeStateIssuer
1679736490MedicaidNC
SW1333MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1679736490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BEHAVIORAL HEALTH CENTER CMC RANDOLPH",
            "address_2": "501 BILLINGSLEY ROAD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111009",
            "telephone_number": "704-358-2710",
            "fax_number": "704-358-2938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BEHAVIORAL HEALTH CENTER CMC RANDOLPH",
            "address_2": "501 BILLINGSLEY ROAD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111009",
            "telephone_number": "704-358-2700",
            "fax_number": "704-358-2716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISHLER",
        "first_name": "AMY",
        "middle_name": "L.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-02",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C006073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679736490",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SW1333",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; 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.