Amanda Thieme, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2017024103 Issued in MO

Practice address

500 Huber Park CT Ste 103
Weldon Spring, MO 63304-8683

Phone

(314) 441-6977

NPI assigned

Dec 9, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1730726852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5203 SHETLAND DR",
            "city": "WELDON SPRING",
            "state": "MO",
            "postal_code": "633047592",
            "telephone_number": "314-596-8798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HUBER PARK CT STE 103",
            "city": "WELDON SPRING",
            "state": "MO",
            "postal_code": "633048683",
            "telephone_number": "314-441-6977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1034 S Brentwood Blvd Ste 555",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631171265",
            "country_code": "US",
            "telephone_number": "314-252-8696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THIEME",
        "first_name": "AMANDA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-09",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2017024103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Weldon Spring, MO
• Providers in Weldon Spring, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.