Amanda Sue Kern, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW 601946619 Issued in WA

Practice address

8011 N Dakota St
Spokane, WA 99208-5708

Phone

(208) 620-1871

NPI assigned

Oct 6, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 1, 2023 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Alternative Community Enrichment Services, Inc.

  dba ACES Community Services

  • Social Worker
  • Coeur d'Alene, ID
  • NPI 1093935728
  NPD (past)
• Pathways of Idaho, LLC

  dba Clarvida

  • Community/Behavioral Health Agency
  • Boise, ID
  • NPI 1326466988
  NPD (past)

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

{
    "created_epoch": "1254787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381276800000",
    "number": "1689909871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8011 N DAKOTA ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992085708",
            "telephone_number": "208-620-1871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8011 N DAKOTA ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992085708",
            "telephone_number": "208-620-1871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERN",
        "first_name": "AMANDA",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-06",
        "last_updated": "2013-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-29818",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW 601946619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Lynn Kepsel
• Alexander Nicholas Kerby
• Megan Marie Kerby
• Ginette Ann Kerkering, P.T.
• Michael C Kerkering, M.D.
• Darrin Edward Kern
• Shira Kern, PHD
• Steven M Kernerman, D.O.
• Jennifer J. Kerns, O.D.
• Adrian Kathleen Kerr

• Clinical Social Worker in Spokane, WA
• Providers in Spokane, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.