Individual provider Active NPI

Amanda E Bieber-Mayberry, MSW

  • Clinical Social Worker
  • Tacoma, WA
National Provider Identifier
1699067249
Registry record updated May 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW60050238 Issued in WA
Practice address
3402 S 19TH St
Tacoma, WA 98405-2487
Phone
(253) 301-5470
NPI assigned
May 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2019

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 LW60050238 WA Primary

Addresses

Primary practice location

3402 S 19TH St
Tacoma, WA 98405-2487

Mailing address

3402 S 19TH St
Tacoma, WA 98405-2487
Phone (253) 301-5470

Other practice location 1

1660 S Columbian Way
Seattle, WA 98108-1532
Phone (206) 762-1010 ext. 66656

Other identifiers 1

IdentifierTypeStateIssuer
LW60050238OtherWALICENSURE

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LW60050238WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1305244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556755200000",
    "number": "1699067249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3402 S 19TH ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984052487",
            "telephone_number": "253-301-5470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3402 S 19TH ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984052487",
            "telephone_number": "253-301-5470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1660 S Columbian Way",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981081532",
            "country_code": "US",
            "telephone_number": "206-762-1010 x66656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BIEBER-MAYBERRY",
        "first_name": "AMANDA",
        "middle_name": "E",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-13",
        "last_updated": "2019-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60050238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE",
            "identifier": "LW60050238",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2019; 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.