Individual provider Active NPI

Amy L. Stephen, MSW, LCSW

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1740574110
Registry record updated Jun 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS21155 Issued in CA
Practice address
2305 Meade Ave # 3
San Diego, CA 92116-4113
Phone
(619) 806-6238
NPI assigned
Jun 2, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2011

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 LCS21155 CA Primary

Addresses

Primary practice location

2305 Meade Ave # 3
San Diego, CA 92116-4113

Mailing address

2220 Camino de la Reina
Unit 114
San Diego, CA 92108-5527
Phone (619) 806-6238

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
LCS21155CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1306972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306972800000",
    "number": "1740574110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 CAMINO DE LA REINA",
            "address_2": "UNIT 114",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921085527",
            "telephone_number": "619-806-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 MEADE AVE # 3",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921164113",
            "telephone_number": "619-806-6238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHEN",
        "first_name": "AMY",
        "middle_name": "L.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-02",
        "last_updated": "2011-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS21155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2011; 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.