Amanda Renee Ellingwood, BSW, MSW, LSW, ICADD

Primary specialty

Social WorkerTaxonomy code 104100000X

License

0910018549 Issued in IN

Practice address

4427 E 800 N
Alexandria, IN 46001-8750

Phone

(765) 748-8679

NPI assigned

Oct 4, 2012

Last updated

Oct 4, 2012By the provider in NPPES

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": "1349308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349308800000",
    "number": "1740532472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4427 E 800 N",
            "city": "ALEXANDRIA",
            "state": "IN",
            "postal_code": "460018750",
            "telephone_number": "765-748-8679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4427 E 800 N",
            "city": "ALEXANDRIA",
            "state": "IN",
            "postal_code": "460018750",
            "telephone_number": "765-748-8679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLINGWOOD",
        "first_name": "AMANDA",
        "middle_name": "RENEE",
        "credential": "BSW, MSW, LSW, ICADD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-04",
        "last_updated": "2012-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "0910018549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corey Martinez DDS LLC- Binford (Martinez Dentistry)
• Jessica Lee Cottrell, LPN
• Katera Lynn Couch
• Christopher Michael Day, PHARM.D.
• Hubert Dolubizno
• Yochana R Gavva, MD
• Drew Joseph Gleitsmann, HSPP
• Rhonda A Goforth, FNP
• Alampartap Grewal, DDS
• Kimberley Ann Gull, NP

• Social Worker in Alexandria, IN
• Providers in Alexandria, IN by specialty
• Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2012; 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.