Amanda Mariscal, LCSW, MPH

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

010181 Issued in CT

Practice address

113 Lielmanis Ave
Hurlburt Field, FL 32544-5613

Phone

(850) 881-1020

NPI assigned

Jul 11, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Reliance Health, Inc

  • Case Management Agency
  • Norwich, CT
  • NPI 1518198597
  NPD (past)

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1720430051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 LIELMANIS AVE",
            "city": "HURLBURT FIELD",
            "state": "FL",
            "postal_code": "325445613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 LIELMANIS AVE",
            "city": "HURLBURT FIELD",
            "state": "FL",
            "postal_code": "325445613",
            "telephone_number": "850-881-1020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8th Medical Group",
            "address_2": "Kunsan AB",
            "address_purpose": "LOCATION",
            "city": "APO",
            "state": "AP",
            "postal_code": "962641162",
            "country_code": "US",
            "telephone_number": "063-470-4841",
            "country_name": "United States",
            "address_type": "MIL"
        },
        {
            "address_1": "189 Storrs Rd",
            "address_purpose": "LOCATION",
            "city": "Mansfield Center",
            "state": "CT",
            "postal_code": "062501683",
            "country_code": "US",
            "telephone_number": "860-456-1311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18th Medical Group Unit 5142",
            "address_purpose": "LOCATION",
            "city": "APO",
            "state": "AP",
            "postal_code": "96368",
            "country_code": "US",
            "telephone_number": "315-630-4780",
            "country_name": "United States",
            "address_type": "MIL"
        }
    ],
    "basic": {
        "last_name": "MARISCAL",
        "first_name": "AMANDA",
        "credential": "LCSW, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-11",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "010181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0040404564",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bobby Ray Linville, LCSW
• Michel Larayne Long, LCSW
• Lena T. Longmire-Lyons, LMHC
• Jose Encarnacion Lucio
• Sindy Johanna Maldonado
• Marc Marrero, IDMT
• Justin R Martin, MD
• Sheridan Ann Martin, O.D.
• Jennifer June Sillence Masino, PSY. D.
• Corrine Lynn Materese, LCSW

• Clinical Social Worker in Hurlburt Field, FL
• Providers in Hurlburt Field, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; 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.