Individual provider Active NPI

Emanda Wimberly, LICSW

  • Clinical Social Worker
  • Opelika, AL
National Provider Identifier
1730843434
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4849C Issued in AL
Practice address
810 N Uniroyal Rd
Opelika, AL 36804-9726
Phone
(256) 861-0129
NPI assigned
Oct 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

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 4849C AL Primary

Addresses

Primary practice location

810 N Uniroyal Rd
Opelika, AL 36804-9726

Mailing address

810 N Uniroyal Rd
Opelika, AL 36804-9726
Phone (334) 703-9167

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
4849CALMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1730843434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 N UNIROYAL RD",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368049726",
            "telephone_number": "334-703-9167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 N UNIROYAL RD",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368049726",
            "telephone_number": "256-861-0129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIMBERLY",
        "first_name": "EMANDA",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-28",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "4849C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Opelika, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; 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.