Active NPI
Amanda J Stratton Kirk, LICSW
- Clinical Social Worker
- Peabody, MA
National Provider Identifier
1770737314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1171750
- Practice address
- 9 Centennial Dr
Suite 202
Peabody, MA 01960-7939 - Phone
- (978) 927-9410
- Fax
- (978) 531-1355
- NPI assigned
- Nov 10, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 214428 | MA | |
| Clinical Social Worker | 1041C0700X | 1171750 | MA | Primary |
Addresses
Primary practice location
9 Centennial Dr
Suite 202
Peabody, MA 01960-7939
Mailing address
9 Centennial Dr
Suite 202
Peabody, MA 01960-7939
Phone (978) 927-9410
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1171750 | MA | MD | Clinical Social Worker |
| 214428 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404086400000",
"number": "1770737314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 CENTENNIAL DR",
"address_2": "SUITE 202",
"city": "PEABODY",
"state": "MA",
"postal_code": "019607939",
"telephone_number": "978-927-9410",
"fax_number": "978-531-1355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 CENTENNIAL DR",
"address_2": "SUITE 202",
"city": "PEABODY",
"state": "MA",
"postal_code": "019607939",
"telephone_number": "978-927-9410",
"fax_number": "978-531-1355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STRATTON KIRK",
"first_name": "AMANDA",
"middle_name": "J",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-10",
"last_updated": "2014-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "214428",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "1171750",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peabody, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.