Amber Smith, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW022115 Issued in PA

Practice address

18 Campus Blvd Ste 100
Newtown Square, PA 19073-3240

Phone

(484) 466-5090

NPI assigned

Sep 15, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Melanated Healing

  • Mental Health Counselor
  • Havertown, PA
  • NPI 1073255311

  Clinical

  NPD Authorized official

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1750051348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 WILDE AVE",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190263418",
            "telephone_number": "267-800-5420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 CAMPUS BLVD STE 100",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190733240",
            "telephone_number": "484-466-5090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AMBER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-15",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW022115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@melanatedhealing.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "18 Campus Blvd Ste 100",
            "city": "Newtown Square",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190733240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jasmine M Simmons
• Caitlin Simpson
• Joseph A. Sims, DO
• Hrant Siradarian
• Shinette Sirmans-McRae, M.D.
• Chelsea Victoria Smith, MS, BCBA
• Lauren Elizabeth Smith, RDN
• Mack Stevenson Smith, RBT
• Rebecca Ann Smith
• So Love Autistic Center

• Clinical Social Worker in Newtown Square, PA
• Providers in Newtown Square, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.