Individual provider Active NPI

Amber Lia Benamou, LCSW

  • Clinical Social Worker
  • Fort Lauderdale, FL
National Provider Identifier
1770923955
Registry record updated Jun 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW12591 Issued in FL
Practice address
2900 W Prospect Rd
Fort Lauderdale, FL 33309-2519
Phone
(954) 731-5100
Fax
(954) 497-3857
NPI assigned
Jul 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW12591 FL Primary
Mental Health Counselor 101YM0800X SW12591 FL

Addresses

Primary practice location

2900 W Prospect Rd
Fort Lauderdale, FL 33309-2519

Mailing address

4740 N State Road 7
201
Lauderdale Lakes, FL 33319-5839
Phone (954) 486-4005

Other identifiers 1

IdentifierTypeStateIssuer
010317400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250828003854 NC Practitioner - Clinical Social Worker 4183076359 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Henderson Behavioral Health, Inc. Past Accepting new patients
Henderson Behavioral Health, Inc. PastSince Jan 14, 2012 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1770923955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 N STATE ROAD 7",
            "address_2": "201",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333195839",
            "telephone_number": "954-486-4005",
            "fax_number": "954-497-3857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 W PROSPECT RD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333092519",
            "telephone_number": "954-731-5100",
            "fax_number": "954-497-3857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENAMOU",
        "first_name": "AMBER",
        "middle_name": "LIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-02",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12591",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW12591",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010317400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.