Amanda Conley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW23151 Issued in FL

Practice address

103 Century 21 Dr Ste 201
Jacksonville, FL 32216-9295

Phone

(904) 862-6039

NPI assigned

Jun 13, 2024

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

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.

• Ebtide Counseling Group, Inc

  • Clinical Social Worker
  • Jacksonville, FL
  • NPI 1144871351
  NPD

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

{
    "created_epoch": "1718236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1750124319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5308 POND VIEW DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322583417",
            "telephone_number": "904-386-4179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 CENTURY 21 DR STE 201",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322169295",
            "telephone_number": "904-862-6039"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 University Blvd S Ste 119",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322162737",
            "country_code": "US",
            "telephone_number": "904-337-9950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5308 Pond View Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322583417",
            "country_code": "US",
            "telephone_number": "904-386-4179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONLEY",
        "first_name": "AMANDA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-13",
        "last_updated": "2024-06-13",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW23151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Joseph Conigliaro
• Michiele Dian Conklin
• Sarah Conklin
• Fatima Conley-Johnson, LMHC
• Alana Estore Conley, PA-C
• Kathryn E Conley
• Conlon Physical Therapy, LLC
• Dennis J Conlon, DDS
• Connect to Care of Florida, LLC
• Connect to Care, LLC

• Clinical Social Worker in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.